Tips to finding a Doctor

When starting the search to find a doctor for yourself, it’s important to keep a few things at the top of your mind. To try and keep the cost of your insurance low, insurance companies have formed contracts with doctors. To keep the cost as low as possible for you, try to use doctors who your insurance company has contracted with. Each insurance company publishes a list of these doctors on their website. When you use these doctors you get a better price.

When you pick your own doctor who is not contracted, that doctor can charge whatever they feel they’re worth. However, the insurance company is only going to pay a limited amount. For some types of plans (HMO’s) the insurance company will pay non-network doctors nothing at all. In this circumstance, you may get stuck with the bill.

If you’re moving insurance companies it’s a good idea to check if your doctor accepts the new insurance company. You can do this by calling in to your doctor and explaining the details of your new insurance. Insurance companies also publish a list of doctors they work with. They call these lists Provider Directories.

Unfortunately, locating the specific provider directory may be harder than it sounds.

For example, many doctors accept the Anthem PPO plans but not the Anthem Pathway PPO. Or they may take the Hometown HMO but not the Hometown Premier HMO.

The things you will need when you look for a doctor are:

  1. Name of the doctor, location & name of the practice they’re affiliated with
  2. Name of your insurance company (Saint Mary’s, Anthem, Aetna…)
  3. The name of the Plan: PPO, HMO, Point of Service…
  4. Name of the NETWORK your plan uses: Hometown Premier HMO, Anthem Pathway PPO, Aetna Open Choice PPO…
    • Some companies only have one network in Nevada. This makes finding a doctor in Reno easy.
    • All companies must list their network name in the summary of benefits or the summary plan description
    • If you’re having trouble finding the network, contact us and we will be glad to help.

Two of the most important things to check before switching insurance companies: Is your doctor covered? Is your prescription covered?