Why It Matters to Keep Your Doctors in the Same Network

Why It Matters to Keep Your Doctors in the Same Network

One of the most common issues I’m seeing this open enrollment season is how tricky it can be to keep all your doctors covered by the same insurance plan. Many clients don’t realize how important it is to try and keep all of their providers within the same hospital network.

Here’s why that matters:

Not All Plans Cover All Hospitals

In most areas, Blue Cross Blue Shield Advantage and some managed care plans are the only ones accepted by all major hospital systems. But they’re also among the most expensive. So if you’re seeing a cardiologist at Baylor Scott & White, a PCP at St. David’s, and a specialist at Seton, it may be nearly impossible to find an affordable plan that keeps them all in-network—unless you go with a higher-tier plan.

Why Referrals and Networks Matter

If you belong to a group like Austin Regional Clinic (ARC), they’re great about referring you within their own network. That makes referrals easier—especially on HMO plans like MyBlue Health. It also ensures faster scheduling, less confusion, and fewer billing issues.

If you have MyBlue Health and stick with ARC, you’re usually in good shape. But if you need a specialist outside ARC? Things get messy. You could end up driving to San Antonio and still waiting weeks to get in.

What About Baylor Scott & White?

Many clients on Baylor Scott & White Health Plans have told me they’ve had trouble finding specialists. Billing issues, pre-authorization headaches, and limited network options are common complaints. In some cases, there’s simply no specialist available in-network—yet the insurance company won’t approve an out-of-network visit because “one exists” in their system, even if they aren’t accepting new patients.

Which Hospital Systems Take the Most Plans?

Here’s a rough breakdown:

• St. David’s – Accepts most major plans (except Baylor Scott & White).

• Seton – Accepts many plans, but fewer than St. David’s.

• Scott & White – Only takes Scott & White Health Plan and Blue Cross Blue Shield Advantage (not MyBlue Health).

What Can You Do?

• Try to keep your doctors within the same hospital network if possible.

• If you rarely see a particular doctor, you might be okay paying cash for occasional visits.

• Use a licensed broker to help you map out networks before you choose your plan.

If you went it alone last year, don’t do that again! I can help you compare plans, check your doctor and prescription compatibility, and save you hours of stress.

📅 Open Enrollment ends December 15. Book your review now!