Disease and Conditions - Index D

The controlled care projects contracts of sign with certain doctors and hospital to deal with their members of plan. Your plan can refer to them as suppliers. This group of suppliers is often called the network of the plan. Like you, they agreed to follow the rules of the plan.

Your insurance company could not pay you to go in a supplier who is not in his network. If it pays you to employ a supplier apart from your network, it can pay less than it for a supplier of network. In one or the other case, you are responsible for the part of the invoice that the plan does not pay. Even if your doctor belongs to the network of the plan, him or it can prefer to send patients to a hospital which is not in the network.

If so, to ask whether your doctor can send to you to a hospital in the network. If it is not possible, you can ask the insurance company if it will approve the use of the hospital of outside-of-network. If no other arrangement can be taken, you could have to see another doctor.