Access to doctors with health reform
This post will give you information about your Access to doctors with health reform. The new health reform plans that are created and will be ready to go either through the State or Federal Exchange by January 1, 2013. The plan designs have been decided by the carriers who participate. In fact, the criteria that the carriers use to determine rates is established. So what will the provider network look like?
It may be better not to think about that questions because the answer could be disturbing. At this point, it looks as though all the insurance carries are filing new provider networks to go with the new health reform plans that are coming out. The likely reason for this is because insurance companies feel they will need to lower the provider reimbursement in order to “make the math work”.
Provider reimbursements under health reform
These reimbursements will likely be somewhere around the Medicare or Medicaid reimbursement level. That is a lower payment than most providers receive from the insurance company on a non Medicare or Medicaid contract. (There is a substantial discount off charges on a regular health contract as well however). As a result, the companies will create a new network with lower payments. After they do this, they will see how many providers than can get to participate. This will substantially reduce the network, therefore it may not include your doctor or hospital.
While the new plans may offer strong benefits and reasonable premiums for many, it will not doubt also not have nearly as many doctors to choose from. For more specific information on the health reform benefits, premiums and other info CLICK HERE
If you need further information, please contact us. You can reach either by phone at (203)796-5403 or by email at [email protected]