Warning – Is Your Provider Network Shrinking?

narrow doctor networksFollowing implementation of the Affordable Care Act, it seems that insurance companies are looking for ways to “trim the fat” and keep costs down. One growing trend is restricting the number of doctors and hospitals within health plan networks. This option helps keep health care costs down, but benefits you by providing somewhat lower health insurance premiums if you’re willing to accept these narrow networks. But are the savings really worth it?

In a narrow-network plan, insurance companies negotiate lower payment rates to providers and facilities for the services that are provided. This helps keep insurance payments low, and as a result, reduces premiums on your end. But how hard is it to find a doctor or hospital when you really need one?

When you need medical care, finding a participating provider or facility where you live can be tricky – if not almost impossible! You’ll likely find a variety of available general practitioners in the area, but finding a specialist, on the other hand, can be a daunting task! Because of limited availability, you’ll likely find that it’s difficult to get an appointment and you’ll probably have to drive a further distance from your home to find a participating provider.

In some places, New York for instance, most plans have no out-of-network coverage, and tracking down in-network providers is the ultimate challenge. The government has plans to set limits on how restricted or narrow a network can be, but this may take some time. When selecting a health plan, it’s best that you carefully review the provider network to ensure you have access to a variety of providers and facilities in your area. If you don’t mind taking the extra steps necessary with a narrow network, you could be rewarded with lower premiums!

If you have any questions about a plan’s provider network, your ColoHealth Advisor is here to help. Simply contact us at 866-749-2045.

What has your experience been with ACA plans and narrow networks?

  Date posted: Tuesday, October 28th, 2014
Category: Health Care Reform, Health Insurance



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