Navigating any health care plan can be complicated. Just when you think you have it figured out, you stumble across some new jargon and legalese that only makes it more convoluted and frustrating. This is especially true when dealing with managed-care plans and provider networks. How do you get treatment from an out-of-network health care professional? In this article we'll look at how managed health care companies treat non-network services.
Non-network services are any type of medical care outside the network of providers set up by your managed-care plan. Because most networks make every attempt to include the most common types of provider, like family-care doctors and pediatricians, there might not be a wide variety of specialists. The dermatologist or nutritionist you saw on one plan might not be available on another. Your doctor should refer you only to in-network specialists, but it can get tricky when the specialist you need is not included in the network.
So what happens if you do have to visit a non-network doctor? How much should you expect to pay?