Unless you have a PPO, you MUST always go through your primary care physician for all care except emergency room and urgent care visits. If you need to see a doctor right away and your primary care doctor can't see you, you go to the emergency room or urgent care. You can go to any emergency room anywhere and you are covered however emergency room visits are covered in your plan. Most plans require you to visit specific urgent care centers, so check them out first. It would be impossible for the doctor's office to research everybody's insurance coverage to find out how their plan will cover them. They can check to see if the insurance is one they accept, but that doesn't mean you're covered for that visit. It's important to understand these things BEFORE you need urgent medical care. You might try asking the doctor's office to bill you at the same rate they've negotiated with your insurance company. Many times that's a tiny fraction of the cash price.