---
title: When Your Insurance Network Changes, What Happens to Your Psychiatrist?
description: Can you keep your psychiatrist when your network changes? See who keeps in-network rates for 90 days, your choices after a job change, and private pay in Texas.
---

[Clear Answers | With Dr. Allison McDade MD](https://www.healthandharmonypsychiatry.com/blog)

# [When Your Insurance Network Changes, What Happens to Your Psychiatrist?](https://www.healthandharmonypsychiatry.com/blog/insurance-network-changes-and-your-psychiatrist)

 Written by [Dr. Allison J. McDade, MD](https://www.healthandharmonypsychiatry.com/blog/author/dr-allison-j-mcdade-md) | Nov 3, 2026, 3:18:04 AM

- Medically reviewed November 2, 2026
- Updated November 2, 2026

Maybe you've opened a letter from your health plan and learned that the psychiatrist you trust is leaving its network.

Or maybe a new job brought a new plan, and the doctor who knows your story was outside its network.

And maybe you've wondered whether you'd have to start over and tell it all again, while everyone else still counts on you.

You deserve to know your options before anything changes, and a physician who already knows your story.

This guide shows what a network change means for your care, and how to keep it steady.

The answer

**When your psychiatrist leaves your plan's network, you may need a new psychiatrist to keep paying in-network rates.** If you're a continuing care patient, such as someone in treatment for a serious and complex illness, you may be able to keep seeing your psychiatrist at in-network rates for up to 90 days, federal No Surprises Act guidance explains. At Health & Harmony, care is private pay, so when your job or your plan changes, Dr. McDade can stay your physician. **Know your options before your coverage changes.**

Her story explains [why Dr. McDade built a different model of care](https://www.healthandharmonypsychiatry.com/why-a-different-model).

## What happens when your psychiatrist leaves your plan's network?

When your psychiatrist's contract with your plan ends, seeing them becomes out-of-network care. Your plan's network is the doctors and other providers it has contracted with, HealthCare.gov explains.

You may be able to keep in-network rates for a time, and you can find an in-network psychiatrist for what comes next, federal No Surprises Act guidance explains. Your plan can tell you what staying with your psychiatrist would cost, so you can decide whether to stay or switch. Your psychiatrist can also recommend someone in your network, and your plan's website or member handbook lists who is in it.

**Ask first, then decide whether to stay or switch.**

## Who counts as a continuing care patient?

Federal No Surprises Act guidance names five groups who can keep seeing a provider at in-network rates for up to 90 days.

Continuing care patients include people who are

- Undergoing treatment for a serious and complex illness
- Undergoing institutional or inpatient care
- Scheduled to get non-elective surgery
- Pregnant and undergoing treatment
- Terminally ill

If you're one, federal law requires most plans to tell you when your provider leaves the network. If you ask, your plan must keep covering the treatment that makes you a continuing care patient, on the same terms, for up to 90 days from the day it gives you the notice. Keep the notice, since that day starts the 90 days. The rule applies when a contract ends or goes unrenewed, unless it ended over fraud or quality problems.

Ask your psychiatrist and your plan whether your care fits.

**Ask before you count on the 90 days.**

## Why do networks change?

Networks shift for many reasons. A psychiatrist's contract with a plan can end or go unrenewed, and an employer can change the plans it offers.

When large employers expected costs to rise in 2026, 16% changed the company that runs their plan, and 7% switched to a plan with a tiered or narrower network, KFF's survey found. In a tiered network, you pay more to see some providers, HealthCare.gov notes.

 What large employers did when they expected costs to rise in 2026

- Asked workers to pay more of the premium44%
- Raised deductibles or other cost sharing for most services21%
- Changed the company that runs their plan16%
- Switched to a tiered or narrower network7%

From KFF's 2026 Employer Health Benefits Survey, firms with 200 or more workers that offer health benefits, for their largest plan, four of the seven actions it reports. Changing the company that runs a plan and switching to a tiered or narrower network, in bold, can reshape a network.

If you're a continuing care patient, the 90 days can also apply here. Federal law covers the case where your employer's plan ends its contract with the company that insures it and your psychiatrist falls out of network.

**Check your network every year, even on the same plan.**

## What happens when you change jobs or plans?

A new job often means a new plan, with its own network. If the psychiatrist you see is outside it, you may have to start over with someone new and tell your story from the beginning.

 How long workers had been with their employer, January 2026

- Workers ages 25 to 343.0 years
- All wage and salary workers4.1 years
- Workers ages 55 to 649.6 years

From the Bureau of Labor Statistics, Employee Tenure in 2026, the median years wage and salary workers had been with their current employer.

Half of workers who earn a wage or salary had been with their current employer 4.1 years or less, the Bureau of Labor Statistics found. When a job ends, HealthCare.gov lists two main ways to keep coverage, continuation coverage, known as COBRA, and a Marketplace plan.

Your optionHow it worksYour psychiatrist

1. 01Your new job's plan
   
   How it worksIts own network and its own rules
   
   Your psychiatristLook up your psychiatrist before you enroll
2. 02COBRA
   
   How it worksIf you qualify, pay to stay on your job-based plan for a limited time, usually 18 months. You usually pay the full premium plus a small fee
   
   Your psychiatristYour old plan's network, while it lasts
3. 03A Marketplace plan
   
   How it worksApply within 60 days of losing job-based coverage
   
   Your psychiatristCheck its network before you choose a plan

**Look up your psychiatrist before you change plans.**

You've carried everyone through every change. Now choose care that stays with you.

[Find Care That Understands Me](https://www.healthandharmonypsychiatry.com/book-an-appointment)

## Why does staying with one physician matter?

With one physician over time, each visit picks up where the last one left off. Dr. McDade gets to know what is usual for you, from your work hours to how you sleep, so each visit goes to what has changed.

Research points the same way. In a 2018 BMJ Open review of 22 studies from nine countries, 18 linked seeing the same doctor over time with longer lives, psychiatrists included.

 A 2018 review of continuity and longer lives

- Studies in the review22
- Studies that linked seeing the same doctor with longer lives18

From Pereira Gray and colleagues' systematic review in BMJ Open, 2018, of studies from nine countries with generalist and specialist doctors. All of its studies were observational, so they show a link.

**Your story keeps building when your physician stays.**

## How can you keep your care steady through a change?

A few calls now give you time to choose.

Before your coverage changes

- Ask your psychiatrist whether you're a continuing care patient
- Ask your plan what staying with your psychiatrist out of network would cost
- Ask for a copy of your records, or have them sent where you choose
- Book your next visit while your current coverage still applies
- If you need someone new, ask whether they're in your network and taking new patients

Ask your plan for its answers in writing, and note the date of each call. If you do move to someone new, bring your records and a short summary of your history in your own words, so your new psychiatrist starts with your story in hand.

**Start early, and keep your records close.**

## How does private pay keep one physician through a change?

Private pay, also called self-pay or cash pay, means you pay the practice directly for each visit. Your time with Dr. McDade needs no approval from a health plan, and when your job or your plan changes, your physician can stay the same.

Dr. McDade sees every patient herself, because that is the work she trained for. Your care centers on your relationship with her, built on trust and continuity from your first evaluation on.

Every visit is a [telepsychiatry](https://www.healthandharmonypsychiatry.com/telepsychiatry) visit by secure video, for patients in Houston and across Texas, so your physician stays the same if you move within Texas.

If you fill a prescription through your health plan, the plan's rules still apply, and some prescriptions need its approval first. When one does, Dr. McDade calls and helps however she can, as part of her standard fees.

**The same physician, whatever your plan does next.**

If you need help now

If you are in crisis or thinking about suicide, call or text 988 or chat at [988lifeline.org](https://988lifeline.org/) to reach the 988 Suicide and Crisis Lifeline. If you are Deaf or hard of hearing, use your preferred relay service or dial 711, then 988. In an emergency, call 911 or go to the nearest emergency room. This practice does not provide emergency services.

## What happens after you reach out?

Here is each step, from the first call to your first follow-up.

1. 01
   
   ### You reach out
   
   Book on the [booking page](https://www.healthandharmonypsychiatry.com/book-an-appointment), or call 832.387.6088.

   Online or phone
2. 02
   
   ### A brief screening
   
   A brief screening first confirms that telepsychiatry fits your needs.

   Before the visit
3. 03
   
   ### Intake in the portal
   
   You'll complete a few intake forms in the patient portal, then meet with Dr. McDade for a full evaluation.

   Patient portal
4. 04
   
   ### Your first evaluation
   
   Dr. McDade hears your story and reviews your history and your health, over 60 to 90 minutes. Understanding relies on context, and some stories need more time.

   Unhurried
5. 05
   
   ### A plan built with you
   
   You and Dr. McDade discuss each option in depth. When therapy is the better starting point, she refers to therapists she knows well.

   Collaborative
6. 06
   
   ### Follow-up with Dr. McDade
   
   Follow-up visits run 15 to 30 minutes by secure video.

   Steady

The [psychiatric evaluation page](https://www.healthandharmonypsychiatry.com/services/psychiatric-evaluation) explains what the first visit covers, and the [telepsychiatry page](https://www.healthandharmonypsychiatry.com/telepsychiatry) explains how video visits work.

**Your story comes first.**

## Questions about network changes and private pay

 How much does care cost?

Care is private pay. A new evaluation with Dr. McDade is $465, and follow-up visits with Dr. McDade are $275. You receive a good faith estimate before your first visit.

 Does Dr. McDade take insurance?

No. Care is private pay, with rates set in advance and shared up front. You have the right to receive a [Good Faith Estimate](https://www.healthandharmonypsychiatry.com/good-faith-estimate) explaining how much your medical care will cost. Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

 Does the 90-day rule apply to me?

It depends on your care. The rule covers continuing care patients, such as people in treatment for a serious and complex illness, and it applies to most types of health insurance, federal No Surprises Act guidance explains. Ask your psychiatrist whether you fit the definition, and ask your plan what it would cost to stay.

 Can I get my records if I change psychiatrists?

Yes. You have the right to see and get copies of your health information, with a few exceptions, the U.S. Department of Health and Human Services explains. In Texas, physicians must respond to a request within 15 business days, the Texas Medical Board says. You can also ask your doctor to share your information directly with others. Patients here can view their records in the patient portal.

 Can I keep seeing Dr. McDade if my insurance changes?

Yes. Care here is private pay, so your visits continue when your job-based or Marketplace plan changes. The practice can give you a superbill to send to your plan if it offers out-of-network mental health benefits. It lists the visit, its billing codes, and what you paid.

 Will I see the same doctor at every visit?

Yes. Health & Harmony Psychiatry is a physician-only practice, and every visit, from your first evaluation through every follow-up, is with Dr. McDade.

Sources for the facts on this page.

- [Action plan: Doctor going out-of-network](https://cms.gov/medical-bill-rights/help/plan/insurance-doctor-leaving-plan), CMS.gov, October 6, 2026
- [42 U.S.C. 300gg-113, Continuity of care](https://www.law.cornell.edu/uscode/text/42/300gg-113), U.S. Code
- [Network](https://www.healthcare.gov/glossary/network/), HealthCare.gov
- [Non-preferred provider](https://www.healthcare.gov/glossary/non-preferred-provider/), HealthCare.gov
- [2026 Employer Health Benefits Survey](https://www.kff.org/health-costs/2026-employer-health-benefits-survey/), KFF, October 22, 2026
- [Employee Tenure in 2026](https://www.bls.gov/news.release/tenure.nr0.htm), U.S. Bureau of Labor Statistics, September 24, 2026
- [See Your Options If You Lose Job-Based Health Insurance](https://www.healthcare.gov/what-if-i-am-losing-job-based-insurance/), HealthCare.gov
- [Continuity of care with doctors, a matter of life and death? A systematic review of continuity of care and mortality](https://bmjopen.bmj.com/content/8/6/e021161), Pereira Gray and colleagues, BMJ Open, 2018
- [Get it. Check it. Use it.](https://hhs.gov/hipaa/for-individuals/right-to-access/index.html), U.S. Department of Health and Human Services, reviewed July 31, 2026
- [Patient Information and Medical Records](https://www.tmb.texas.gov/resources/for-the-public/patient-information-and-medical-records), Texas Medical Board

This guide explains network changes in general terms and is not insurance or legal advice.

The information on this website is for general education and does not constitute medical advice or create a physician-patient relationship. For care, please schedule an appointment.

## Keep reading

- Her story[Why Dr. McDade chose a different model](https://www.healthandharmonypsychiatry.com/why-a-different-model)
  
  Her story, and what one physician with time makes possible.
- Service[Medication management](https://www.healthandharmonypsychiatry.com/services/medication-management)
  
  How medication management works with this practice.
- Service[Telepsychiatry](https://www.healthandharmonypsychiatry.com/telepsychiatry)
  
  How video visits work with this practice.
- About[About Dr. McDade](https://www.healthandharmonypsychiatry.com/about)
  
  Her training, her credentials, and how she works.

## Care Through Connection

The physician who knows your story, through every change.

Book the first visit online, or call 832.387.6088 with questions. A parent or guardian books for anyone under 18, and a brief screening confirms fit before your first visit.

[Find Care That Understands Me](https://www.healthandharmonypsychiatry.com/book-an-appointment)

Health & Harmony Psychiatry does not provide emergency care. If you are in crisis or thinking about harming yourself, call or text 988, or call 911. Ages 6 to 70. Health & Harmony Psychiatry provides care by secure video to patients physically located in Texas at the time of their appointment.

[View full post](https://www.healthandharmonypsychiatry.com/blog/insurance-network-changes-and-your-psychiatrist)

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