How to determine if a narrow network health plan is right for you

How to determine if a narrow network health plan is right for you

Nov 12 2023

A narrow network health plan offers coordinated care at a reduced monthly premium, but is it the right choice for you and your family?

As health care costs continue to climb, health plans are partnering with health systems to offer narrow network plan options that increase access and affordability of care.

With a narrow network plan, families get high quality care at a reduced cost. Here are some facts about narrow networks that may be helpful as you begin planning for next year’s health care plan. This year, open enrollment starts Nov. 1 and concludes Jan. 16, 2024.

What is a narrow network?

A narrow network is a popular health plan for many consumers who are looking to save money and receive care from one provider system. For example, Priority Health offers narrow network plans with Corewell Health West Michigan Network, Bronson Healthcare Partners, Southeast Michigan Network and Trinity Health East Network.

The narrow networks are made up of medical providers who have a proven track record of practicing and delivering care in a more efficient and cost-effective manner by focusing on health outcomes.

How do I know if a narrow network is right for me?

There is no one-size-fits-all health plan, so it’s important to consider your family’s unique health care needs before you begin searching. Health plans with narrow networks typically have lower premiums, but they also limit the number and type of providers available to you.

It may be helpful to identify your preferred doctors before enrolling in this type of plan. In many cases, you may already be seeing doctors within one health system—making a narrow network plan a great fit for you and your family.

In addition, if you’re young and generally healthy, a narrow network plan may be a practical choice. The lower premiums balance out your limited options, especially if you only visit your doctor for routine checkups.

Why should I choose a narrow network?

Lower monthly premiums are just one of several benefits to narrow network plans:

  • Coordinated care within one health system and easy access to your comprehensive medical records
  • No referral needed when care is provided by the designated health care system
  • Narrow networks can decrease long-term costs by encouraging individuals to develop a relationship with their primary care doctors
  • Many also offer additional benefits such as mental health support, virtual care, care management for those that are most at-risk for chronic health conditions and access to cost saving tools.

Some final things to consider.

  • Narrow networks require that you receive care only from a specific health system of doctors and hospitals. Make sure you do your research and choose a nationally recognized, high ranking health system.
  • Check to see that the health plan you want includes your preferred doctors and hospitals in network and make note of which plans these providers participate in.
  • If your ideal doctors don’t participate in the plan you’re considering, look for an alternative. Take the time to find an in-network doctor, transfer your medical records and get established with that doctor before you get sick or need care. Or if you don’t want to switch providers, explore other health coverage plan options.

Narrow networks can be an excellent tool for consumers who are looking to save money and may already receive care from one specific provider system. With a little preparation and research, you can determine if a narrow network is the right choice for you and your family.

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