Research Your Doctors' Hospital Affiliations
A doctor's hospitalAn institution whose primary function is to provide diagnostic and therapeutic inpatient services, for a variety of surgical and non-surgical medical conditions. In addition, most hospitals provide outpatient services, including emergency care. affiliations are the hospitals where he or she can provide care (also known as hospital privileges). It's important to know your doctor's hospital affiliation before you need care because your costs will be based on the hospital you choose.
And when you're choosing new doctors, be sure to check their hospital affiliation before you make an appointment.
Primary Care Provider (PCP)
The hospital(s) where your PCPAn institution whose primary function is to provide diagnostic and therapeutic inpatient services, for a variety of surgical and non-surgical medical conditions. In addition, most hospitals provide outpatient services, including emergency care. is affiliated may affect where he or she will referIf a PCP determines that an individual requires specialized care, the PCP may "refer" that person to an appropriate specialist. A referral is often required by a managed care plan before the plan will cover certain services. you for specialist care. This is because it's easier for him or her to coordinate your care when you are at a hospital where your PCP is affiliated. Check your PCP's hospital affiliation and talk to him or her about where you would like to be referred.
When you need specialty care, you should check where your specialist is affiliated before getting care. This is because if your specialist is going to send you to a hospital for care, your costs for that care will be based on the hospital where you receive your care.
How to Check Your Doctor's Hospital Affiliation
Use our Find a Doctor tool:
Call your doctor's office and ask where he or she is affiliated.
For help finding a doctor's hospital affiliation or a Lower Cost Share hospital, call Member Service at 1-888-636-4808.
Once you know a doctor's hospital affiliation, check if the hospital or affiliated location is Lower or Higher Cost Share.
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