Buying coverage by March 31? Make sure your doctor works with your plan

ROCHESTER, NY (03/18/2014)(readMedia)-- Planning on doing some spring skiing? Well, if you break your leg, you might pay $3,500 more out of your pocket if you see doctors who are not in your health insurer's network, according to a new Excellus BlueCross BlueShield infographic.

Providers who participate with your health plan are part of the health insurer's network, and you'll typically pay less for their services than you would for services from out-of-network providers.

"With two weeks left to sign up for a health plan on the NY State of Health marketplace, uninsured individuals still have time to do their homework and select coverage that meets their needs," said Lynne Scalzo, vice president, business strategy and administration, Excellus BCBS.

"An important piece of that homework is checking to see whether your doctors participate with your new health plan," she added. "If you purchase a less expensive health plan and the insurer doesn't contract with your doctor, for example, you might end up paying more money out of your pocket in the long run."

Individuals have until March 31, 2014, to purchase a health plan through NY State of Health.

The infographic, Out of Your Pocket, lists examples of possible out of pocket costs for individuals if they see out-of-network doctors instead of in-network providers for certain services:

• You could pay $10,000 more out of your pocket for a knee replacement if you received services from an out-of-network doctor instead of an in-network provider.

• You could pay $2,500 more out of your pocket for a Cesarean section if you received services from an out-of-network doctor instead of an in-network provider.

• You could pay $500 more out of your pocket for a concussion if you received services from an out-of-network doctor instead of an in-network provider.

Out-of-pocket costs can vary for individuals depending on their type of health plan. If your health plan has a deductible, for example, you'll have to pay the deductible amount for covered services before the insurer pays all or part of the remaining costs.

"It's also important to consider a health plan with a broad provider network," said Jamie Kerr, M.D., Vice President and Chief Medical Officer, Excellus BCBS. "You might not need a specialist today. But a health plan with a broad provider network will increase the chances that the specialists you may need tomorrow will be working with your insurance plan."

To view a mobile-friendly version of the infographic, go to http://brand.excellusbcbs.com/infographics/pocket.php. To view a PDF, go to excellusbcbs.com/factsheets or click here.

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Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.8 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools in our Step Up program. To learn more, visit excellusbcbs.com.