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Navigating insurance

Danielle has United through work. She buys United on her own.

Same logo on the card. Different doctors inside.

Danielle has United Healthcare through her job.

She sees Dr. Reeves, an orthopedist, twice a year for a knee issue. He’s in-network. She never thinks about it.

A single United Healthcare group plan card listing the five providers Danielle uses — Dr. Reeves, Dr. Chen, St. Mary’s Hospital, Dr. Patel, and CityHealth Urgent Care — all of them in-network.

United Healthcare

Group plan (employer)

Same Insurer, Different Networks: Group vs

Dr. Reeves (ortho)
In network
Dr. Chen (PCP)
In network
St. Mary’s Hospital
In network
Dr. Patel (cardio)
In network
CityHealth Urgent Care
In network
Illustrative. Danielle’s group plan network.

Danielle’s company switches to ICHRA. She buys a United plan on the individual market.

Same carrier. Same blue logo on the card. She assumes everything carries over.

The group plan card sits beside a new United Healthcare individual plan card. Three of the five providers appear on both; Dr. Reeves and Dr. Patel are listed as out of network on the individual plan.

United Healthcare

Group plan (employer) — ended

Same Insurer, Different Networks: Group vs

Dr. Reeves (ortho)
In network
Dr. Chen (PCP)
In network
St. Mary’s Hospital
In network
Dr. Patel (cardio)
In network
CityHealth Urgent Care
In network

United Healthcare

Individual plan (ICHRA)

Same Insurer, Different Networks: Group vs

Dr. Reeves (ortho)
Not in network ✗
Dr. Chen (PCP)
In network
St. Mary’s Hospital
In network
Dr. Patel (cardio)
Not in network ✗
CityHealth Urgent Care
In network
Illustrative. Two United plans, two provider networks.

She books her next appointment with Dr. Reeves. The office calls back.

“Dr. Reeves isn’t in-network on your new plan.” Danielle is confused. It says United Healthcare. It IS United Healthcare. But her group plan used one provider network. Her individual plan uses a different one. Same carrier — different panel of doctors.

A flagged box holding the United Healthcare card mark, headed “same logo, different network”, noting that Dr. Reeves is not in Danielle’s new plan.

Same logo. Different network.

Dr. Reeves is not in Danielle’s new plan.

The card in her wallet looks identical. The panel of doctors behind it is not.

Illustrative. The carrier matched; the network did not.

The good news: Danielle had other options. She just didn’t know to look.

Three other plans in her area include Dr. Reeves — two from different carriers, one from United on a different network tier. She could have filtered by provider name when shopping. The individual market has more plans than group — the key is searching by doctor, not by logo.

Three plans available to Danielle — Aetna Silver HMO at $410 a month, United Gold EPO at $520 a month, and BCBS Silver PPO at $465 a month — each one carrying Dr. Reeves in-network.

Plans that include Dr. Reeves in Danielle’s area

Aetna · Silver HMO
$410/mo
United · Gold EPO (different network tier)
$520/mo
BCBS · Silver PPO
$465/mo

All three carry Dr. Reeves in-network.

Search by provider name, not carrier logo

Illustrative. Three plans in Danielle’s area that include Dr. Reeves.