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What if the doctor I want doesn't take my health insurance plan?

Dr. Michael Roizen, MD
Internal Medicine

If the doctor you want doesn’t take your health insurance plan, you still have some options. Check your plan or call your health insurance customer service department to see if you have out-of-network coverage. In some cases, you may be able to appeal to your health insurer to cover a specialist who isn’t technically in the network. There’s always the option to pay yourself -- but remember, many plans have an annual cap on out-of-pocket expenses.

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
If the doctor doesn't accept your insurance but he or she is really your top choice, don't give up. Call the insurance company, and ask if it would consider adding this doctor to its list. If it won't, ask why. Sometimes, if even just a few patients call and ask the insurer to add a doctor, it will.

Likewise, ask your doctor if you could convince him or her to begin accepting your insurer. And every year when you renew your health insurance (a lovely period in November called "open enrollment" by most employers), call your doctor and make sure he or she intends to keep accepting this insurance plan.

When we're deciding which insurance carriers we'll work with, doctors can be swayed by just a few small factors—and if dropping a plan will create big problems for two or three regular (and well-liked) patients, that can carry weight. So speak up.

YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

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YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment

Everyone needs to become a smart patient. In fact, in the worst cases, your life may even depend on it. Number one bestselling authors and doctors Michael Roizen and Mehmet Oz have written this...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.