Your doctors
Finding out whether a plan covers your doctor
Figures on this page checked . Medicare and marketplace numbers reset every year — if you are reading this long after that date, call and we will tell you what moved.
The hospital does not decide this. The plan does
A hospital or a clinic is not in or out of anything on its own. It signs a contract with an insurance company, one company at a time, and often one plan at a time within that company. So the question is never “does UCHealth take insurance”. It is whether this particular plan, from this particular carrier, for this particular year, has a contract with the people you see.
In plain terms
“In network” The provider has agreed a price with your insurance company. You pay the share your plan sets. Out of network, there is no agreed price, and depending on the plan you may pay a much larger share or all of it.
Two plans from the same company can have different networks. A carrier can be in your county and its narrowest plan can leave out the hospital nearest you. This is the single most common way somebody ends up on a plan that looked right on price and turns out to be wrong in March.
The two systems people here ask about
In Larimer and Weld counties, most of these questions come down to two health systems, and it is worth knowing which buildings belong to which before you start calling.
- UCHealth — Poudre Valley Hospital in Fort Collins, Medical Center of the Rockies in Loveland, Greeley Hospital, and a large network of clinics and specialists across both counties.
- Banner Health — North Colorado Medical Center in Greeley, McKee Medical Center in Loveland, and its own clinics and specialty groups through the region.
There are independent practices and physician groups here that belong to neither, and they contract separately again. A specialist who sees you inside a UCHealth building is not necessarily employed by UCHealth, which matters more than it sounds like it should — it is the reason two bills for one visit can land on different sides of the same network.
We are not going to tell you on this page which plans include which of them. That answer changes every January, it changes for some plans and not others inside the same company, and an agency website that printed it would be publishing something it cannot keep true. What follows is how to get the answer for yourself, and it works in any year.
How to check, in the order that works
Do these in order. Each step catches something the one before it misses, and the last two are the ones people skip.
- Write down the list first. Every doctor you actually see, the hospital you would want to be taken to, and any specialist you have an appointment with in the next year. Names and the practice they work out of, not just “my cardiologist”.
- Call the practice’s billing office, not the front desk. Ask which plans they are contracted with for next year, by the plan’s full name, not by the company’s. “Do you take Anthem” is a question that gets a yes and means nothing.
- Check the carrier’s own directory too. Every carrier publishes one, and Connect for Health Colorado links to them from each plan while you are comparing. Two sources agreeing is worth a great deal more than either one alone.
- Check the hospital and the doctors separately. A hospital being in network does not put every physician group inside it in network. Anesthesia, radiology, pathology and the emergency group are frequently contracted apart from the building.
- Write down who told you and when. The date, the name, the plan you asked about. If a directory turns out to be wrong later, that note is the difference between an argument and a correction.
Do this before you enroll, not after
Once Open Enrollment closes you generally cannot change plans because a doctor turned out to be outside the network. That is not a qualifying life event. The check costs an afternoon and the mistake costs a year.
Directories are wrong more often than you would like
A provider directory is a carrier’s record of contracts it has signed, updated on the carrier’s own schedule. Doctors leave practices, practices join systems, and contracts end on dates nobody publishes. A directory can be accurate the day it was built and stale the day you read it.
That is why the phone call to the billing office comes first in the list above. They know what they signed. It is also why two sources beat one: when the directory and the practice disagree, you have found something worth resolving before you enroll rather than at a reception desk with a co-pay in your hand.
Networks can also change during the year you are already in. If that happens while you are in the middle of a course of treatment, do not assume you have to stop — call the carrier and ask what continuity of care they offer, and call us as well.
What we do with your list
Send us the names and we run them against every plan available in your county before you choose one, and we tell you which of your doctors each plan keeps and which it does not. That is the work, and it costs you nothing — we are paid the same by the carrier whichever plan you end up on.
What we will not do is guess. If a directory and a practice disagree, we say so and we go and find out, because a network answer that turns out to be wrong is the kind of wrong that shows up as a bill.
Questions about doctors and networks
Which plans cover UCHealth in Fort Collins?
It depends on the year and on the individual plan rather than on the company, which is why this page teaches the check instead of printing a list. Contracts between carriers and health systems are renegotiated annually, and two plans from one carrier can differ on this.
Send us your doctors and the hospital you would want, and we will tell you which of the plans available in your county include them this year. That answer is free, it takes us very little time, and it is current on the day we give it to you.
My doctor left the network in the middle of the year. Now what?
Call the carrier first and ask about continuity of care. If you are in an active course of treatment, plans commonly allow you to keep seeing that provider at in-network cost for a period, and you have to ask for it.
Losing a provider mid-year is not by itself a reason the marketplace will let you change plans. Ask us anyway — there may be something else in your year that does open a window, and it costs nothing to find out.
The hospital is in network. Does that cover everyone in it?
No, and this is the gap that produces the surprise bills people talk about. Anesthesiologists, radiologists, pathologists and emergency physicians are often contracted separately from the hospital they work in.
For anything planned, ask the hospital which of the groups involved in your procedure are contracted with your plan. For an emergency you cannot do this, and federal protections against surprise billing exist for exactly that reason.
The cheapest plan has a smaller network. Is that a bad idea?
Not automatically. A narrower network is one of the straightforward reasons a plan costs less, and if the people you see are inside it, you are paying less for the same care.
It is a bad idea when nobody checked. Run your own list against it first. If your doctors are in, the smaller network costs you nothing; if they are not, the premium saving is not a saving.