Can I See My Doctor if I Switch to an Obamacare Plan?

It’s understandable to be concerned about the availability of doctors when considering a switch to an Obamacare plan. Let’s explore this issue and provide valuable insights to help you make an informed decision.

What is PHCS?

PHCS (Provider Health Choice) is a network that connects doctors and hospitals to insurance companies. Some doctors and hospitals choose to only work with PHCS, rather than individual insurance companies. This means that if your doctor is part of PHCS, your insurance company needs to have an agreement with PHCS in order for your doctor to accept your insurance.

Marketplaces and PHCS

When you purchase health insurance through the Health Insurance Marketplace, you can choose from a variety of plans from different insurance companies. However, not all insurance companies have agreements with PHCS. Therefore, it is possible that the marketplace plan you choose may not cover your doctor if they are only part of PHCS.

Checking Plan Coverage

Before enrolling in a marketplace plan, it is important to check if your doctor is covered. You can do this by using the Health Insurance Marketplace website and searching for plans that include your doctor in their network. You can also contact your doctor’s office and ask if they accept any marketplace plans.

Options if Your Doctor is Not Covered

If your doctor is not covered by any marketplace plans, you have a few options:

Talk to your doctor: Discuss the possibility of paying out-of-pocket for their services or negotiate a reduced rate.
Consider a different plan: You may need to select a different marketplace plan that includes your doctor in its network.
Seek an alternative doctor: You may need to find a new doctor who accepts marketplace plans.

Seeking Professional Assistance

If you are having difficulty navigating the Health Insurance Marketplace or finding a plan that meets your needs, it is recommended to seek assistance from a licensed insurance agent. They can help you understand your options and make an informed decision.

Remember, switching to an Obamacare plan does not necessarily mean you will be unable to see your current doctor. By researching plan options and considering your options, you can ensure continued access to the healthcare you need.