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Finding In-Network Health Care Providers

Steps to take guide

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In-Network vs. Out-of-Network Providers
  • In-Network Providers:
    Have a contract with your health insurance company to provide you with care and services at a discounted rate.
  • Out-of-Network Providers:
    Do not have a contract with your health insurance company to provide you with care or services at a discounted rate.
This is important because going to in-network providers may save you money.
Steps to Finding In-Network Health Care Providers
Contact Your Health Care Provider
  • If you are unsure if a health care provider or medical facility is in your network, you can always contact them directly!
  • Ask them to confirm that all the health care providers you will see are part of your plan’s network.
  • Check the hospital, health system, or facility’s website to see if they list the insurance plans they take.
Check Your Plan Information
  • Many health insurance companies have an online tool to find in-network health care providers near you. Your health insurance company’s website can usually be found on your health insurance ID card.
  • Look for the tool that is usually called “find a doctor,” or “find a provider” on the website and fill in the required information. The website will show you a list of in-network health care providers near you.
  • Some health insurance companies may also send you printed resources or offer an app you can download with this information.
  • It is still helpful to contact the health care provider and confirm that they are part of your plan’s network.
Ask Your Health Insurance Company
  • Check the back of your health insurance ID card or go to your health insurance company’s website to find their customer service phone number.
  • Tell them you want to make sure you are using health care providers who are in-network and if they can help you with that or provide more information. They should be able to verify which health care providers are in-network for you.
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Disclaimer: The information on this site is intended for U.S. residents only and is provided purely for educational purposes. Health, legal, regulatory, insurance, or financial related-information provided here is not comprehensive and is not intended to provide individual guidance or replace discussions with a healthcare provider, attorney, or other experts. All decisions must be made with your advisers considering your unique situation. © Triage Cancer & Pfizer Inc. 2024 

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remove.svgremove.svg-mobileChanges to Medicare in 2025 will cap your out-of-pocket (OOP) costs for covered Part D Drugs:
  • $2,000 is the total maximum OOP cost you will pay for all your covered Part D drugs in 2025. This includes your yearly deductible.
  • You also have the option to spread your OOP costs out over the course of the year by opting-into the Medicare Prescription Payment Plan.
Medicare Prescription Payment Plan
  • You can opt-in to the Medicare Prescription Payment Plan if you have Part D coverage or a Medicare Advantage Plan with prescription drug coverage.
  • Participation is voluntary and you must opt-into the program in order to participate.

Example

Opt-in during open enrollment or anytime during the plan year

Example

No payment required at pharmacy

Example

Receive monthly bills from your Part D plan
How to Opt-in
  • You can opt-in by contacting your plan directly, either by phone, paper request, or online.
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