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Newsletter Article


Health Plans Give Consumers a Guide to Networks and Insurance

By Rebecca Adams, CQ HealthBeat Associate Editor

October 23, 2014 -- The health insurance industry recently released a 22-page guide to help consumers understand how to enroll in coverage, evaluate different plans' provider networks, and recognize that costs may be higher when a patient gets care from a provider that is not in a plan's network.

The information is designed to help patients, especially those gaining coverage for the first time, realize that there are financial consequences if they are not treated by doctors and hospitals within an insurer's network.

The issue has gotten notice because some consumer advocacy groups and providers have recently charged that the networks health plans are offering through the new insurance marketplaces are tighter than insurers have provided in the past or for other types of coverage.

The National Association of Insurance Commissioners is working on revising its model state law on the adequacy of networks and will be holding a call to discuss those changes.

Health and Human Services Secretary Sylvia Burwell said that federal officials will monitor those efforts before deciding whether they will take additional steps to ensure that the number and types of providers that consumers can use is sufficient.

"Over the next few weeks, families across the country will be making important decisions about their health care coverage," America's Health Insurance Plans Foundation President Karen Ignagni said. "Empowering consumers in their health care decisions is a key priority, and this guide is designed to help individuals navigate and understand the choices available to them."

The next marketplace sign-up period runs from Nov. 15 to Feb. 15.

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