In a previous post, we outlined the recommendations made by the Department of Health and Human Services (HHS) last week to encourage health insurance carriers to take steps toward easing policyholders’ transition to new 2014 ACA-compliant health plans. We want to provide clarification on a couple of the points, and dissuade anyone from believing their insurance carrier will simply cover any out-of-network care or off-formulary drugs throughout the month of
In-network vs. Out-of-network Care
What is a network? A network (also called provider network or preferred providers) is a group of medical providers (hospitals, doctors, specialists, pharmacies, etc.) that have contracted with an insurance company to provide medical care at an agreed-upon rate. What is in-network vs. out-of-network care? In-network care is medical care obtained from a provider within your plan’s network. Out-of-network care is medical care obtained from providers outside of your plan’s
Why Do I Need an Insurance Agent?
People often ask this question. And with just cause. After all, it seems pretty straightforward to go online, click a few boxes, and purchase health insurance. Or, if your employer offers group coverage, you simply read the employee handout and make your selection. But, without professional advice, can the average person really understand all of the provisions of an insurance plan and navigate an often-complicated claims process? Sometimes, it takes
