When insurers like Cigna or UnitedHealthcare end contracts with major health systems, patients can be left scrambling. This guide offers clear steps to protect your care and your wallet.

1. Confirm the change

• Don’t rely on headlines alone.
• Call your doctor’s office and your insurer to verify whether your provider is still in-network.

2. Ask about transition coverage

• Many states require insurers to offer a “continuity of care” period (often 60–90 days).
• This lets you keep seeing your doctor at in-network rates if you’re in the middle of:
  • Pregnancy care
  • Active cancer treatment
  • Post-surgery follow-up
  • Chronic illness management

3. Request a continuity-of-care form or ask what is required for continuity-of-care

• Insurers often have a form that your provider can sign to extend in-network coverage temporarily.
• Ask for this right away if you’re receiving ongoing treatment.

4. Check your options to switch insurance

• Open Enrollment: typically each fall, you can switch to another plan that covers your provider.
• Special Enrollment Periods (SEPs): Regulators sometimes allow members to change plans immediately when contracts end.
• Medicare Advantage: You may be able to return to traditional Medicare outside of normal windows if your provider leaves the network.

5. Get alternative in-network options

• Ask your insurer for a case manager to help you find in-network doctors.
• Double-check that new providers are truly in-network (insurer directories can be outdated).

6. File an appeal or complaint (if needed)

• If you’re denied coverage for ongoing care, you can file:
  • An internal appeal with your insurer.
  • An external appeal to your state’s Department of Insurance.
• State insurance departments and attorneys general can step in during big disputes.

6. Keep records of EVERYTHING

• Save all letters, emails, and call logs with your insurer and provider.
• Documentation helps if you need to appeal or file a complaint later.

Key Tip: Don’t wait until your next appointment. Call your doctor and your insurer now to understand your options.

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The post What to Do if Your Doctor or Hospital Goes Out-of-Network appeared first on Gwell - Nutrition, Wellness, and Healthcare Advocacy.