Buying health insurance by March 31? Make sure all of your doctors work with your plan

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 plan’s network, according to a new Univera Healthcare infographic.

Providers, including radiologists and anesthesiologists, who participate with your health plan are part of its “network,” and you’ll typically pay less for their services than you would for services from out-of-network providers.

“With days left to sign up for a health plan on the NY State of Health marketplace, uninsured individuals still have time to do their homework on their various options,” said Lynne Scalzo, vice president, business strategy and administration, Univera Healthcare. “That includes checking to see if all of their doctors participate with the health plan they’re about to select.”

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

“A health plan with a large provider network is more likely to include the specialists you may need tomorrow,” said Richard Vienne, D.O., Univera Healthcare vice president and chief medical officer. “That’s why an important criterion for selecting a health plan should be the breadth of its provider network.”

The Univera Healthcare infographic, Out of Your Pocket, lists examples of possible higher costs for individuals who see out-of-network doctors instead of those who are in their health plan’s network.

· 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, you’ll have to pay the deductible amount for covered services before the insurer pays all or part of the remaining costs.To view a mobile-friendly version of the infographic, go to http://brand.univerahealthcare.com/infographics/pocket.php. To view a PDF, go to UniveraHealthcare.com/factsheets.