The Benefits Beyond Your Health Insurance Plan

​​There’s a chance your doctor or hospital leaves your plan’s network. Don’t worry, it doesn’t normally happen without a warning – you should get a letter, email or phone call if your doctor will no longer be covered. Here are a few steps you can take to find new in-network care or choose a new plan that covers your current doctor:

• ​Search our Provider Finder^® tool: Provider Finder lets you search for doctors guaranteed to be covered by your plan. Make sure you log in to get the most accurate and personalized search results. Search for a new provider. 

• ​Find a new plan during Special Enrollment or Open Enrollment: You can choose a new plan during Open Enrollment, which typically begins November 1 and ends January 15. If you go through a big life change, like getting married, having a baby or moving, you may be able to pick a new plan during Special Enrollment.

Essential health benefits, sometimes just called essential benefits, are types of care your plan must cover to follow Affordable Care Act (ACA) guidelines:

1. Emergency services, including hospitalization and ambulatory outpatient services
   
2. Maternity and newborn care during and after pregnancy
   
3. Pediatric care, including dental and vision coverage
   
4. Behavioral health and substance use care, like counseling and psychotherapy
   
5. Prescription medicines
   
6. Rehabilitative services, including devices and services to for physical and mental support
   
7. Lab tests required or recommended by your doctor
   
8. Preventive and wellness care, like annual screenings and check-ups

You can, but you’ll likely have to pay for that care out of pocket. To avoid paying out-of-pocket costs, try to use in-network doctors, take your preventive health seriously, or rely on telehealth or immediate care centers.

Your most affordable health care option, when possible, is to visit an in-network doctor.