Is My Doctor In An Insurance Company’s Network?

One of the key factors to decide if a given health plans is the right plan for you , is to check if the hospitals and doctors you prefer are in the network of the insurance carrier. For Los Angeles in 2016 the networks of Blue Shield and Anthem are growing and both carriers offer a true PPO, so if it is needed you may go out-of network. Visiting an out-of-network however can be very costly as the insurance carrier will only pay 50 % of the rate he thinks is feasible. So for example a doctor charges $ 500 for a visit , the insurance says it should cost only $ 100, than they are paying $ 50 while you owe  the remaining $ 450.- to the doctor, who is out-of-network.

Oscar a new carrier will offer an EPO, meaning that they will not pay doctors out-of-network however they are very competitive priced and offer in Los Angeles doctors of the Providence Hospital and UC hospitals, primary care doctor visits are free and on the simple plus plan specialist cost $ 50.00.

No matter what, it is advisable to contact your healthcare provider before purchasing a plan to confirm that they are under the policy.  It can also be possible that your health care provider is considering joining with an insurance company in the future, so check that information out as well.

Many Californians are overwhelmed by the task of figuring out the new affordable care acts and how to maximize the benefits for your family. As your agent, we can help. Email us at or receive a free premium quote. We will make sure that we find you and your family an affordable health plan in California for 2016.