You’re scheduling an appointment with a doctor. It could be a well visit or one to discuss a particular concern. You’ve agreed upon a time and asked whether the doctor accepts your insurance. You’re all set, right?

Maybe not. Many doctor’s offices will accept your insurance even though they don’t participate in your insurance plan. The doctor may not have signed a contract with your insurance company agreeing on a total charge for the visit. This means your insurance may not cover the visit as you are expecting. It may cover a smaller than normal amount and you’ll be stuck with bills to pay the difference.

You can avoid a situation like this by asking a different question. When you call to schedule your appointment ask if the doctor “participates” in your insurance plan.

It is also important to recognize that some doctor’s offices are very large and have a number of doctors in the facility. If you have a specific doctor that you want to see, make sure your particular doctor and the office as a whole participate in your insurance plan. For instance, if you have Medicare or Medicaid some doctors in your practice may accept those, while others in your practice do not.

Avoid unexpected medical bills by ensuring that your doctor and the doctor’s office participate in your insurance. All it takes is the right question: “Do you participate in my insurance plan?”

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