What if my doctor leaves my network?
Short answer
You may need to pay more to keep seeing them, or switch to an in-network doctor. In some situations you may get temporary continued coverage, and leaving a network can matter when you choose next year's plan.
Why it happens
Insurers and doctors renegotiate their agreements regularly. When an agreement ends, the doctor becomes out-of-network for your plan.
Your options
- Find a new in-network doctor. Use your insurer's provider directory or call member services.
- Ask about continuity of care. If you're in the middle of treatment — for example, pregnancy or an ongoing serious condition — you may be able to keep seeing the doctor at in-network rates for a period.
- Pay out-of-network costs. On some PPO plans you'll still get partial coverage. On HMO and EPO plans you'll usually pay the full cost.
- Change plans. If your doctor is in a different plan's network, you can switch at open enrollment, or earlier if you have a qualifying life event.
Check before you renew
Networks change every year. Always check your doctors in next year's directory before renewing.
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