In-Network vs Out-of-Network
Part of how you save money with insurance results from your insurance company having a special partnership with your doctor. Your doctor agrees to provide their services to all of the people insured by your insurance company for a discounted rate.
Because of this arrangement, you have to use doctors that already have partnerships with your insurance company.
If you visit a doctor that does not have a partnership with your insurance company, that doctor is called an out-of-network provider. Your insurance company will not help you pay the bill if you use an out-of-network provider.
Call your insurance company or look at their website to determine which doctors are in-network.
Primary Care vs. Specialists
A primary care physician is usually the person who you will see whenever you get sick or need a check-up. They are generally the providers who:
- Keep track of your health records.
- Monitor any chronic conditions you have.
- Refer you to a specialist if you need one.
A specialist is a doctor you will see who need a specific kind of care (cardiologist, surgeon etc).
- To be able to see a specialist, you usually have to visit your primary care doctor first, so they can give you a referral that allows you to make an appointment with a specialist.