What to Do If Your Physician Is Not Part of Your Medical Plan & How to Change Doctors After

11/15/20232 min read

person holding round clear container
person holding round clear container

Having a trusted physician who understands your medical history and provides quality care is essential for your well-being. However, sometimes you may find that your physician is not part of your medical plan. This can be a frustrating situation, but there are steps you can take to address it and find a new doctor who meets your needs. In this article, we will discuss what to do if your physician is not part of your medical plan and how to change doctors after.

1. Understand Your Medical Plan

The first step is to carefully review your medical plan to understand its network of healthcare providers. Most insurance plans have a network of doctors, hospitals, and clinics that they work with, and they often provide a list of these providers. Check if your current physician is listed as part of your plan's network. If they are not, it means they may not be covered by your insurance, or you may have to pay higher out-of-pocket costs to see them.

2. Contact Your Insurance Provider

If your physician is not part of your medical plan, reach out to your insurance provider for guidance. They can provide you with a list of in-network doctors in your area who are covered by your plan. Ask them about the process for changing doctors and any necessary paperwork or forms that need to be completed.

3. Research New Doctors

Take the time to research new doctors who are part of your medical plan's network. Consider factors such as their specialties, experience, location, and patient reviews. You can use online directories or ask for recommendations from friends, family, or other healthcare professionals.

4. Schedule an Appointment

Once you have identified a new doctor, contact their office to schedule an appointment. During this initial visit, communicate your medical history, concerns, and any ongoing treatments or medications. This will help the new doctor understand your needs and provide appropriate care.

5. Transfer Medical Records

To ensure continuity of care, request the transfer of your medical records from your previous physician to your new doctor. This will help your new doctor have a comprehensive understanding of your medical history and make informed decisions about your healthcare.

6. Notify Your Previous Doctor

It is courteous to inform your previous physician that you will be changing doctors. This can be done through a phone call or a written letter. It is important to maintain a positive relationship with your previous doctor, as they may be able to provide valuable insights or recommendations for your new doctor.

7. Follow Up with Your New Doctor

After your first visit with the new doctor, assess if they meet your expectations and provide the level of care you require. If you are satisfied, continue with regular appointments and establish a long-term relationship. If not, you may need to repeat the process and find another doctor who better suits your needs.

Changing doctors can be a daunting process, but it is crucial to ensure that you have access to quality healthcare within your medical plan. By following these steps, you can navigate the process smoothly and find a new physician who can provide the care you deserve.