How does out-of-network coverage work?

we're gonna tackle one of the pitfalls that customers fear when choosing a plan what happens if I do see a doctor a hospital I go out-of-network there's three things you want to be aware of right off the top first off if you this does happen to you you're not totally out of luck second if you're not a hundred percent certain that your doctor or hospital is in network you may want to try to find a plan that does feature out of network coverage and third if you do find yourself out of network you might have to file your own claims and you might end up paying more than if you did see any network doctor or facility so I'm going to walk you through how to use a health com to find a plan that has

both in and out of network coverage and if you do have to file a claim we'll talk about how to do that and the timeline related to that to start let's find a plan that does feature out of network coverage to do this we'll go ahead and use a health com sorting tool once you find a plan you'll need to click on the plan name to verify it has out-of-network coverage this will launch the plan details page on this page you find tons of great information including what type of plan and whether or not the plan includes out of network coverage so

you can see here that the plan does in fact have out of network coverage so what does that mean that means if you do choose a plan that does have out of network coverage you'll be able to see a doctor or provider that isn't necessarily in your plans Network so if you do wind up at a doctor or hospital that says they don't take your insurance company your insurance will still cover a portion of the covered medical expenses but if you do see a provider that's out of network generally a higher cost sharing responsibilities and you'll have to file your own claims these claims are filed directly with the insurance companies so a health insurance doesn't see your claims or any

the health information on your claims but that doesn't mean we can't help you without a network coverage eHealth can help you in three ways we can help you determine what bills and documentation you need in order to file a claim we can help you with timing how long you have to file a claim sometimes it's as quick as 90 days and up to a year so you don't wanna procrastinate and the best way to file an out-of-network claim believe it or not some insurance companies still require that you submit it via fax machine so it's always good to speak with a licensed agent whenever you're making these big decisions so that we can definitely help you out