Wednesday, March 19, 2014

Obamacare Plans Only Required to Have 20% of Essential Community Providers in an Area

This definitely comports with what individuals are seeing out there.  People get lulled into thinking that because they have been with an insurer before, that insurer will be fine for them in a state Exchange.  But the Exchange-Insurers are are only offering 20% to 50% of the doctors they are normally offering in their employer-insurance plans.  

This is from Jason Millman of the Washington Post:
Health plans selling on the federal marketplaces in 2015 must include 30 percent of area "essential community providers," which are usually health centers and other hospitals serving mostly low-income patients. That's up from a 20 percent requirement in 2014, the first year of expanded overage under the health care law. 
The federal Centers for Medicare and Medicaid Services, which oversees the marketplaces, will also take a much more active role in reviewing health plan networks. CMS, which outlined the new standards in a Friday night letter to insurers, will evaluate whether the plans include enough access to hospitals, primary care doctors, mental health providers and oncologists.