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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.

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Erin Woulfe
Erin Woulfe
Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization or just providing tips and how-to’s to help them make their job easier.”

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