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Narrow insurance networks limit workers' healthcare options

One of the promises of the Affordable Care Act was that Americans would be able to keep their physicians if they wanted to through their insurance benefits. However, Kaiser Health News reported there have been many issues with narrow provider networks, and one family even decided to drop coverage it needed because of this problem.

Many healthcare plans that were offered on the federal and state marketplaces had narrow networks, meaning that the insurance only kicks in if the physician is part of the network. According to a report by the National Center for Policy Analysis, many doctors are actually not in these insurance networks, giving their enrollees few options. While each state's department of insurance is obligated to ensure insurers have adequate networks, Kaiser reported what qualifies as adequate is a big question.

According to Kaiser, a woman ran into issues when she and her husband tried to use her new insurance to see a doctor. The spouses found out that while the insurer said a list of 30 physicians were covered in the network, the vast majority of the doctors on the list told the family that their practices didn't take the plan.

National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.

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Valerie Ortiz

Valerie Ortiz

Over the past 20 years, Valerie Ortiz has worn many hats at National Insurance Services. She currently heads up NIS’ Marketing Team where she helps to create and execute employee benefit communications based upon our public sector clients’ needs. Valerie brings order to the chaos and has a zeal for detail and a talent for organization.