Different types of health insurance plans offer different levels of specialist access. Depending on the importance, access to specialists is to the prospective policyholder can determine what kind of health insurance policy is best for their needs. Through different levels and types of health insurance policies, some policies have an open access policy, other policies require pre-authorization from a primary care doctor before visiting a specialist, and other policies include a network of pre-authorized specialists from which the policyholder may select a specialist to see without the need for primary care authorization. Other health insurance policies offer specialist access through what is called a Health Services Account or HSA, which allows the policyholder to accumulate funds into a tax sheltered account for use on any medical needs incurred within that calendar year.

Depending on the assessed likelihood of the policyholder's need for specialist access may determine what kind of health insurance policies are of interest. With a health maintenance organization, or HMO, there are generally two different ways to access specialists within the network. One way is through open access, where the policyholder may visit any specialist within the HMO network without need for prior authorization from the primary care provider or the HMO administrator. Another way is through prior authorization from the primary care physician, through which all specialist requests and referrals are processed.

Preferred provider organizations, or PPOs, often handle specialist access differently, with co-payment schedules for initial visits and an out of pocket deductible that must be met before specialist services will be covered. Co-payments for specialists tend to be higher, and in-network (pre-approved) and out-of-network specialist deductibles are different, with out-of-network specialists sometimes being as much as double the deductible as for in-network specialists. And Health Service Accounts, or HSA's, reflect the drive towards what the current administration terms consumer driven health care, which allows the consumer to drive how plan benefits are used. Consumers are able to use their accumulated funds for any specialist and also ancillary services, and are free to use in-network or out-of-network providers.

The good news is that access to specialist care is available and consumers have the advantage in the highly competitive insurance industry of being able to research options for access to specialist care and choose the option that is right for their spending habits, budget, and needs. By asking the right questions about specialist access from health insurance agents, comparing and contrasting different policy types and deductible limits, understanding how in-network and out-of-network benefits work where offered, and assessing overall medical health and the likelihood of future need for care from specialists, consumers can determine their level of need to access specialists.