Because of healthcare reform, the size of the provider network is dramatically smaller than in the past. That means doctors who were on the old networks may not be on the new 2014 networks.

Your insurance policy states that it is your responsibility to verify if your doctor, laboratory or hospital is on the insurance plan network. The only sure way to do this is to log onto the insurance company website and do a “Find a Provider” or “Find a Doctor” search. The front office people at the doctor’s office often don’t know about insurance, since that is handled by a separate billing department.

Here’s how to find an in-network doctor, laboratory or hospital.

Anthem Blue Cross

  • Log on to Anthem Blue Cross website at Anthem.com/ca.
  • On the right hand menu of the website under “Useful Tools” select “Find A Doctor.”
  • You will come to a screen to enter your information. This is intuitive except for “Plan Type/Network.” The new health plans have the “Pathway” Network.
  • Enter: “Pathway-PPO/Individual” or “Pathway X-PPO/Individual via Exchange.” They are both the same network.
  • Plan Name: Choose the plan you are on. In reality, the network is the same for all of these plans.

Blue Shield of California                             

  • Log on to the Blue Shield website at www.BlueShieldCA.com
  • Hold curser over “Member” on the top menu and then click on “Find a Provider.”
  • Click on “Select a plan”
  • For type of plan: 2014 Individual and Family PPO Plans (Including Covered California)
  • For Sub-plan: Choose the plan you are on. In reality, the network is the same for all of these plans.

The rest of the search is very intuitive.