HealthSherpa Blog

How to find a doctor who accepts your ACA insurance

Written by HealthSherpa | Oct 16, 2019 9:34:00 PM

Signed up for an Obamacare plan on the Marketplace? You are one step closer to accessing high-quality health care. The next step? Finding great doctors or providers in-network for your health plan. If you’re looking for how to find a doctor who accepts Obamacare, here’s how. 

What is an in-network provider?

Finding a doctor who accepts Obamacare health plans is no different than checking if a doctor is in-network on any other kind of health insurance plan. Just like with any other insurance, you'll want to find a doctor who is 'in-network' for your plan.

First, it’s important to understand what ‘in-network’ means. In the world of health insurance, that’s when a given health insurance plans contracts with a doctor, hospital, or other health care provider to care for those plan’s members. 

How to find an in-network provider

How can you check to find a doctor who accepts your health insurance? There are a number of ways you can check to see if a given doctor is in-network, whether you are looking for a doctor who takes Marketplace insurance or otherwise. First, you can call the phone number of that provider’s office and ask them if they take your specific insurance plan. It’s important to have your insurance card on-hand when doing so. You’ll need to reference your Member ID number (it should be listed on the member ID card you get from your insurance company) and the full name of your plan when doing so. 

You can also check on your insurance company’s website. Insurance companies have search tools that allow you to enter a given plan, and then search for providers who accept that insurance. And this includes Obamacare doctors. You could also try calling the member services department of your insurance company.

HealthSherpa is yet another resource you can utilize to check for Obamacare providers. Have Marketplace insurance? Whether you enrolled through HealthCare.gov or HealthSherpa, you can use HealthSherpa to search for providers. By creating a no-cost, no obligation account with HealthSherpa, HealthSherpa’s search functionality will allow you to automatically see which providers are in-network with your plan. 

Don’t forget that HealthSherpa is a certified partner of HealthCare.gov, allowing you to search, shop, and update information on the Health Insurance Marketplace through a simpler and more streamlined system. Plus, the Consumer Advocate Team is always on hand to help and can be reached at 855-772-2665.

Create an account here to search for a provider that is covered by your ACA health insurance plan.

Details matter

Keep in mind that just because a given provider takes one kind of plan offered by a given health insurance company doesn’t mean that they take all plans offered by that company. That is why if you are calling a doctor’s office or checking that doctor’s website, you’ll want to specifically ask about or check for your exact plan name. 

This is also why searching for an Obamacare provider through HealthSherpa is so simple. Searching through your HealthSherpa account takes the guess-work out of making sure you have your plan information correct in finding providers in your plan's network. 

Need help setting up a HealthSherpa account? The Consumer Advocate Team can get you started. Just call them at 855-772-2665.

If you'd like to sign up for a Marketplace health insurance plan, enter your zip code below to start comparing plans and prices.

Grab our free step-by-step guide to enrolling in Marketplace health insurance here.