How do I know if my health insurance covers out-of-network providers and facilities?

The easiest way is to look at your insurance card and call the member services number on the back. Ask specifically:

• Does my plan include out-of-network benefits?
• What is my out-of-network deductible?
• What percentage does the plan reimburse after the deductible is met?
• What is the “allowed amount” for the [CPT code] in my provider’s ZIP code?

You can also check your plan’s benefits summary, which is usually available in your insurer’s online portal. Look for a section titled “Out-of-Network Services” or “Non-Participating Providers.”