Finding Providers

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.