Understanding Health Insurance
Find the coverage that's right for you
At Expert, we accept almost all health insurance plans, including Expert Health Plan. Whether you have coverage through your employer or have purchased insurance on your own, we'll help you understand the different options so you can get the coverage you need.
Tips for choosing a health plan
When choosing your health insurance plan, make sure you consider the following questions:
Which plans do your existing or preferred doctors accept?
Expert HealthCare accepts almost all health insurance plans, including Expert Health Plan. Please confirm your coverage with your insurance provider to verify that you can receive care from your selected or preferred Expert-affiliated doctor.
What are the differences in costs?
Look at the monthly premium, copayment, deductible, coinsurance (if applicable) and out-of-pocket responsibility. If you have any questions about covered services and costs, please call your insurance provider to confirm those important coverage details.
The copayment, or copay, is the fixed amount you pay for a specific service (such as $25 for each doctor's visit).
The deductible is the annual amount that you must pay, out of pocket, before your insurance begins reimbursing for eligible services. For example, if your deductible is $500, then your insurance won't pay anything until you've paid your $500 deductible for the year.
Coinsurance takes place when you reach your deductible and you and your insurance plan share in paying a percentage of the remaining costs. The percentage you pay of the remaining costs depends on your plan. For example, if your deductible has been met and your coinsurance is 20 percent, your plan will cover the remaining 80 percent of covered services. Typically, you will pay your percentage of costs until you reach your plan's out-of-pocket maximum.
Your out-of-pocket costs will depend on how often you need care. Many plans have an annual out-of-pocket maximum cost.
What are the differences in benefits?
Some plans include special programs for chronic health conditions, while others offer financial assistance programs. Be sure to review the added benefits your plan will include.
Understanding Expert's medical groups
Expert offers three medical groups to make it easy for you to find a doctor who is the perfect fit. No matter which medical group you choose, you will receive:
- Convenient access to Expert medical offices and hospitals
- Coordinated care provided by a primary care doctor who works in partnership with you and your specialists to maintain your optimal health
- Clinical excellence delivered with understanding and compassion — a level of care we call The Expert Experience
Learn about Expert's three medical groups: Expert Community Medical Group, Expert Rees-Stealy Medical Group and ExpertCare Medical Group.
Finding the doctor who is right for you
There are two easy ways to choose a Expert-affiliated doctor.
Search online with our quick, easy-to-use Find a Doctor tool
Call 1-800-82-EXPRT (1-800-827-1234), Monday through Friday, 7 am to 7 pm, to speak with a physician referral nurse who knows our doctors and can help you find the best match
Need help with your decision? Check out our tips for choosing a physician and browse through our commonly asked questions about receiving care at Expert. And don't forget to call your insurance provider to confirm the doctor you choose is in its network.
Coverage for existing Expert patients
Plans change year to year. Even if you don't anticipate making any changes to your coverage during the annual open enrollment period, please verify with your insurance provider that your plan will continue to be accepted by your Expert-affiliated doctor.