Narrow Networks


Some Covered California Plans Narrow Your Choice of Doctors, Hospitals

(Joe Raedle/Getty Images)

(Joe Raedle/Getty Images)

By Pauline Bartolone, Kaiser Health News

When Diane Shore got a letter that her health policy would be canceled, the small premium increase for a new plan didn’t bother her that much. What she’s really troubled by is: “My physicians will no longer be in this network of physicians, or the hospitals won’t be as well.”

“There isn’t something that says: ‘Alert. Be aware. Take action now to be sure this works for you.”

Sixty-two year old Shore owned an IT consulting business in the San Francisco Bay Area, and retired when she sold her business in 2000. She says she wants to stick with the providers that she’s had for years, including the surgeon who operated on her for breast cancer in 1998.

“I have full confidence in her,” she says. “And my primary care doctor has been my primary care doctor for 20 years.”

In Shore’s case, the problem is that the Blue Shield of California plan being offered limits her choice of doctors and hospitals just to Marin County, where she lives, just north of San Francisco. But, she says, “All my doctors are in San Francisco. I live 20 minutes from San Francisco. In fact, it’s more convenient for me to go to San Francisco than to the hospital here in Marin County.” Continue reading

Why Narrow Networks May Not Be Such A Bad Idea

By Dan Diamond, California Healthline

Search Covered California’s website, and you’ll find a list of 33 “frequently asked questions.”

The 33rd and final question — below questions like “Why should I buy health insurance?” and “I’m pregnant and do not have insurance. What health coverage is available for me?” — is this one: “Will patients be able to keep their same doctor when they purchase health insurance through Covered California?”

The question may be last on Covered California’s list, but it’s top-of-mind for many consumers. About one million Californians, and millions of other Americans, are losing their health plans through the individual market and turning to Obamacare’s new insurance exchanges to shop for replacement coverage. And in many cases, it’s still unclear if the family doctor will be coming with them.

The Mechanics Behind Narrow Networks Continue reading