Insurance No Longer Covers Your Primary Care Physician? What Are Your Options?

If you've recently aged out of the health-insurance policy available through a parent's employer or have switched jobs (and coverage) yourself, you may be dismayed to learn that your long-term primary care physician (PCP) is no longer covered as an in-network provider. If you can't afford to pay the out-of-network rates for service, what are your options? And if you do need to find a new in-network PCP, where should you begin? Read on to learn more about managing your health when facing the challenge of finding a new doctor.

What are your options if your insurance plan doesn't cover your PCP?

In some cases, particularly if you've been a long-term patient of your PCP, you may be able to negotiate a discount or cash rate in lieu of running any medical bills through your insurance company. Often, paying out of pocket may be cheaper than paying the out-of-network insurance charge, and you'll be able to continue your relationship with your PCP without incurring many additional costs. 

If your insurance policy offers access to a Health Savings Account (HSA), you should be able to use HSA funds to pay for your PCP care, even if you're not turning in these claims to your insurance provider. You will want to keep careful records of the amounts paid and gather receipts for all transactions, especially if you're paying in cash.

When may you need to find a new PCP?

In some cases, paying out of pocket may not be an option due either to expense or your PCP's unwillingness to quote you a cash price or bill you outside of an insurance policy. If this is the case, and you're unable to afford the out-of-network costs you'd otherwise incur during visits to your PCP, finding a new PCP may be your best option. 

When looking for a new PCP, you'll want to solicit recommendations from local friends and acquaintances while cross-referencing against your insurance company's website to ensure these new options are in-network. Since having a trusting relationship with your PCP is key to identifying and treating any health conditions you may encounter over the years, it can be worthwhile to take your time in selecting a new physician. You may want to make appointments to visit several different doctors before making your final selection so that you can get a solid impression of factors like their bedside manner, their level of knowledge of any chronic conditions you may be dealing with, and even the punctuality and friendliness of the staff at the family practice.