Do You Want a Skinny Network with that Health Plan?

I know what you are thinking…is this the latest specialty coffee at your local Starbuck’s?  Well, it is not.  It is actually what will be happening to a large number of unsuspecting health insurance consumers as early as January 1, 2014.  As we continue to roll into the Affordable Care Act implementation, consumers will be going online to purchase health plans that they do not understand, may or may not be able to afford, and may ultimately lead to disappointment or even worse, catastrophic coverage gaps that were unintended, but clearly stated in the confusing paperwork.

Here in Kentucky, one such example is Anthem’s network for individual coverage.  Many people are accustomed to Anthem having the largest most comprehensive network of hospitals and physicians accept their coverage.  This has been a differentiator for them for many years in our market.  With the launch of their new ACA compliant individual plans, they will have a substantially scaled back network.  Anthem has made a strategic decision to center their health care offerings on two hospital systems, KY One and Baptist Health. 

What does that mean for John Q Public?  Well, in the Louisville area, that means that the 5 Norton Healthcare Hospitals are out of network and will not be available for use by these individual purchasers of Anthem ACA policies.  It also means that if you have an elective procedure performed out of state that you will have no coverage at all!  Zero, Zip, Nada!!!

Humana will have a limited network offering as well.  However, from my understanding, YOU can make the choice if you want a limited network or not and the pricing is sensitive to your choice.  So, if you choose a skinny network, you pay less because you have fewer options for your care choices.  Sounds simple, but the reality is that most won’t pay attention until the bills are not being paid.  That is usually a little too late to work things out.

Looking at this from Anthem’s perspective, this may be the most brilliant strategic move that they could make in this “hostile” environment.  Think about it, Kentucky currently has a “high risk pool”.  All of those individuals have been declined coverage in the past due to a health condition.  They have all been notified that their coverage in the “high risk pool” will be ending on December 31, 2013 and that they would have to be covered through the Kentucky Health Care Exchange.  By limiting the hospitals and doctors that Anthem will allow in the network, they have made themselves the least attractive option to the least attractive risk!!  

In the end, your best bet is to contact an agency that is capable of taking care of you.  Logan Lavelle Hunt is ready to assist you for all of your insurance needs.  We have specialist on staff that can walk you through the most difficult of scenario’s and make sure that you have what you need at the time when you need it the most, at the time of a CLAIM.  Contact us today!  In Peace!