Is your current doctor part of a new health plan's network?

To find out, you can check the printed directory or the plan's website but the best and most accurate method is to call your doctor's office. The printed directory quickly becomes outdated and the website— while more up-to-date—often can't keep up with the constant changes.

To be sure, call your doctor's office and ask if they are covered under the plan and if there are any restrictions you should be aware of.

When I go to the doctor or hospital, what portion of payment am I responsible for?

To understand your responsibility, you must understand what is covered under your policy. When you use a contracted provider, your insurance carrier is billed directly. You will receive an Explanation of Benefits from the carrier which will tell you what your policy paid and what portion you owe. If your insurance refuses to cover the services you receive, then the balance of payment is your responsibility. Your insurance coverage is a contract solely between you (not your employer) and the insurance carrier. When seeking care or having a prescription filled, you should always know the following:

- whether your physician is a contracted provider
- which services are covered and payable
- your portion of payment (deductible, coinsurance, and/or copay)
- date your policy is effective or terminated

You will be personally responsible for payment if your insurance does not pay for services rendered for the following reasons:

- considered a non-covered service by the conditions of your insurance plan
- services exceed the benefit allowed by your particular plan
- services are not authorized
- the provider of services (physician, lab, etc.) is not contracted