Let’s say that you already have a primary care physician or specialist that you love. That means you understand how valuable it is to have a physician that knows you and knows your medical needs. And you understand how important it is that you trust your primary care physician. However, let’s say your employer has changed health insurance Georgia carriers. That has resulted in a change to your health insurance Georgia plan, and to your health insurance Georgia network.

The first thing to do is go to the health insurance Georgia company’s web site and look up their provider directory. You can then search for your physician by name or location. See if you can find your physician’s name included in the health insurance Georgia network provider directory. If they are not there, then you have run into an obstacle, or at least one thing not to like about your plan. But do not despair. There are other things you can do.

You need to know whether your new health insurance Georgia plan is an HMO, PPO, or POS plan. An HMO health insurance Georgia plan means that you have to designate a primary care physician who then has to write referrals for you to see another doctor. This means an extra step every time you want to see your preferred physician. A PPO plan means you get higher benefits if you see a physician that is a part of the health insurance Georgia network. If they are not, the health insurance Georgia plan benefits will be lower. A POS plan is probably your best health insurance Georgia plan option if your doctor is not in the network. A POS plan will pay the same benefits, as they do not use a health insurance Georgia network.

Checking On Out of Network Health Insurance Georgia Plan Benefits

If you have an HMO or PPO health insurance Georgia plan, you will now want to check on your health insurance Georgia plan out of network benefits. Usually, HMO plans do not have out of network benefits. You can then ask your favorite physician if they would be willing to discount your rate as you will have to pay out of pocket because your health insurance Georgia plan does not cover them. If you have a health insurance Georgia PPO plan, and do have out of network benefits, then you will need to learn how to file medical claims in order to be reimbursed your expenses. Or perhaps your physician’s office will file claims for you.

A different approach to solving the problem of not having your favorite physician be a part of your health insurance Georgia plan network, is to ask them if they would be willing to join. You can write a letter to your health insurance Georgia carrier and request that they accept your physician. They will need to call and apply for network membership, which can take some time, but is often retroactive. It helps if you can tell them that their health insurance Georgia network does not include enough providers in their specialty, or as good.