When people purchase health insurance, they’re generally able to visit doctors and other health-care professionals at a negotiated price, determined by their insurance company. The doctors and hospitals that agree to provide care at these negotiated prices are considered “in network” providers.

If you’ve recently enrolled in a plan or are interested in Marketplace coverage, you may be wondering what doctors take Obamacare and how to find out which providers are in network. While specifics will depend on your location and plan details, here’s an overview of how provider networks work and how to find Obamacare insurance providers.

Understanding your coverage options under Obamacare

Just like any other health plan, your Marketplace plan may not be accepted by every doctor, hospital, or provider. Many Marketplace insurance plans have limited or “narrow” networks of doctors and hospitals that agree to accept these lower negotiated prices. To keep monthly premiums lower, insurance companies have in-network health providers (such as doctors and hospitals) that offer services to members for a more affordable monthly price. Learn more about the types of health insurance under Obamacare.

In other words, your costs will generally be lower if you use your plan’s network providers. If you go out of network, you may have higher cost sharing (such as higher copayments or coinsurance costs). Or, in some cases, your plan may not cover the doctor’s visit or hospital stay at all. If you aren’t sure whether a provider is in network, it’s always best to check with your plan. You can learn more about how to check who accepts Obamacare plans below.

Importance of using a network provider that accepts Obamacare

As mentioned, if you’re enrolled in an ACA-compliant plan, it’s generally best to use in-network providers who accept your coverage. A network health provider has a contractual relationship with a health insurance company. This contractual relationship may establish standards of care, clinical protocols, and allowable charges for specific services.

In return for entering into this kind of relationship with an insurance company, a network health provider typically gains in its number of patients. A primary care physician may also receive a capitation fee for each patient assigned to his or her care.

In some instances, you may have to go out of your plan’s network to receive care, or you may receive care from an out-of-network provider and simply not realize it. But as a patient, your costs will generally be lowest if you use in-network doctors and health-care professionals. Remember, your plan has negotiated set rates with its in-network providers. So, as a plan member, you’ll have set and predetermined costs when you use doctors and other healthcare professionals from your plan’s network provider list.

How to check which doctors take Obamacare

Whether you’re currently enrolled in a Marketplace plan, or you’re thinking of changing plans, you’re probably wondering how to find out who accepts Obamacare coverage. There isn’t a single list of doctors who accept Obamacare or Marketplace plans. Instead, each plan has its own list of doctors and providers that have contracted with the plan.

If you’d like to find doctors or health-care professionals who accept Obamacare, you can look up this information in a few different ways:

• Contact your plan directly. On the back of your plan membership card, you can find the member customer service number. Your plan should be able to tell you whether a specific doctor or provider is in-network and accepts your coverage.
• Contact your doctor or provider. If you already have a doctor in mind, you can also contact that provider to ask if they take your insurance.
• Check your plan’s website. Many plans have provider search tools on their company websites. These tools make it easy to find a list of doctors who accept Obamacare coverage and accept your specific plan. You can also look up hospitals, clinics, medical equipment providers and other health-care professionals that take your plan.
• Contact eHealth. As a licensed insurance broker, eHealth offers plans with a wide range of provider options. We can help you check if a certain plan you’re interested in includes your current doctors and providers.

How to find a plan with Obamacare insurance providers

If you’re thinking of changing plans but would like to keep seeing a specific doctor you currently use, it’s a good idea to check whether that doctor is still in network with your new plan. Remember, your costs may be much higher when you use non-network providers – or the plan may not cover your doctor at all. Using network doctors who accept Obamacare will help keep your costs low – especially if you get ongoing or frequent treatment.

eHealth can help you find ACA-compliant plans with a variety of provider options. We can also show you how to check whether a new plan might cover your current doctors. You can start browsing individual and family plans on your own right now if you like; just enter your zip code into the plan finder tool to get started. Or, if you’d like assistance, an eHealth licensed insurance agent can provide trusted expertise with your health coverage questions. Just give us a call or email us to get help and find options that fit your needs.

FAQs about finding doctors that take Obamacare

Can I change my primary care doctor if they don’t accept my Obamacare plan?

Yes, you can change your primary care doctor if they do not accept your Obamacare (Affordable Care Act) plan. It’s important to choose a doctor who is within your plan’s network to ensure coverage. You can do this by contacting your health insurance provider for a list of in-network doctors or by searching on the insurer’s website.

How often can I change my healthcare provider under an Obamacare plan?

Under an Obamacare plan, you are generally allowed to change your healthcare provider anytime during the year. However, it’s advisable to check with your specific plan for any guidelines or restrictions. Some plans might have specific time frames or conditions for making changes to your healthcare provider.

Are there any additional costs associated with seeing a doctor that accepts Obamacare?

There shouldn’t be any additional costs specifically associated with seeing a doctor that accepts Obamacare beyond your plan’s usual costs, such as copays, coinsurance, and deductibles. These costs will vary depending on the specific details of your plan. However, seeing a doctor outside of your plan’s network may result in higher out-of-pocket expenses or full costs. Always verify a doctor’s network status with your insurance plan before scheduling an appointment to avoid unexpected charges.