If your doctor recommends a specialist who isn’t covered by your health plan, ask your insurer what you can do to avoid out-of-network charges – before you visit that doctor (your insurer may have a care coordinator to help). You may find an in-network provider with similar expertise, or you may be able to work with the doctor or hospital to make the case that you need to use a particular specialist. In that case, the insurer may provide a “network adequacy exception” to cover the doctor for you at in-network prices.