Narrow network health plans limit your choices, making it harder to see the doctors you trust.
Over the years, Big Insurance has tightened its grip, cutting costs in ways that don’t always benefit patients or doctors. If you’ve ever felt stuck with limited options or forced to compromise on care, you’re not alone.
But the good news is, you don’t have to settle, there are better alternatives. Keep reading to learn how you can take control of your healthcare.
Narrow Networks in Healthcare
One of the biggest frustrations with health insurance is narrow network insurance plans that restrict which doctors you can see.
While traditional insurance has its place, it often limits your choices and forces you into a system that prioritizes cost over flexibility. Managed care plans like HMOs and PPOs make it even harder by locking you into a select group of providers.
But what if you didn’t have to stay within those limits? What if you had the freedom to choose the doctors and specialists that best fit your needs?
The Problems with Traditional Managed Care
Millions of Americans are stuck in HMO’s and PPO’s, where narrow network health plans dictate which doctors, clinics, and hospitals they can visit.
These managed care plans cut costs by contracting with a limited pool of providers, prioritizing affordability over quality.
Because they control pricing, insurers negotiate steep discounts in exchange for sending a steady flow of patients to their approved network. But that often means only the lowest bidders make the cut—not necessarily the best providers.
For those who rarely need medical care, a narrow network might not seem like a big deal. But when you do need to see a doctor, you quickly realize the trade-off.
With a narrow network health plan, you don’t always get the best care—you get the cheapest care the insurer is willing to cover.
The Affordable Care Act and its Aftermath
The Affordable Care Act (ACA) promised to transform healthcare and lower insurance premiums by thousands of dollars.
But as many have experienced, that’s not exactly how things played out.
Today, managed care plans like HMOs and PPOs dominate ACA-qualified policies on the health insurance marketplace, limiting choices and restricting access to doctors outside their narrow networks.
At the same time, many employers have moved away from traditional indemnity plans in favor of cheaper managed care options that come with more restrictions.
For those who need specialized or high-quality medical care, these limitations can make it much harder to get the treatment they deserve.
Narrow Networks Compromise Quality
These restricted narrow networks often comprise the lowest bidders rather than the most proficient and well-regarded medical professionals.
With managed care plans such as most Obamacare plans, you’re not necessarily getting the best care. You’re getting the most cost-effective care according to the insurance company’s metrics.
That may not be in your best interests.
Think Different to Escape Narrow Networks
The good news?
You don’t have to stay stuck in a narrow network.
There are better options that put the power back in your hands. By stepping away from rigid, one-size-fits-all managed care plans like HMOs, EPOs, and PPOs, you can regain control over your healthcare decisions.
Two of the best ways to do this are through Health Savings Accounts (HSAs) and health sharing plans.
Compare Pricing on the Best HSA Plans Available
Option 1: Health Savings Accounts (HSAs)
Health Savings Accounts are powerful tax-saving vehicles that let you set aside money pre-tax that you can use to pay tax free for future medical expenses.
To contribute, you must be enrolled in a qualified high-deductible health insurance plan. These plans have higher deductibles, but lower premiums than comparable traditional health insurance plans.
But if you have been contributing to an HSA, the higher deductibles won’t be much of a problem: Your HSA funds will be there to pick up the slack… tax-free.
One of the great things about HSAs is that you have complete control over the money. Not the insurance company.
No matter how narrow your insurance company’s care network is, you can still use your HSA dollars with any provider you choose.
To find out more, contact an HSA For America Personal Benefits Advisor for a FREE consultation and quote.
Option 2. Health Sharing Plans
HSAs are just one way to break free from narrow networks, but they’re not the only option.
Health sharing plans offer another approach that puts you in control of your healthcare choices.
How Health Sharing Works
Health sharing isn’t insurance.
It’s a cooperative model where members contribute to a shared fund to cover each other’s medical expenses. These programs are run by nonprofit organizations made up of like-minded individuals who agree to help one another with unexpected healthcare costs.
Instead of paying an insurance premium, members make a monthly contribution (called a “share”), which goes toward covering eligible medical expenses for others in the group. When you need care, you can submit your expenses for sharing.
One of the biggest advantages of health sharing plans is the freedom they offer. Unlike traditional insurance, you’re not stuck in a narrow network. You can see any doctor, specialist, or healthcare provider you choose, without worrying about out-of-network fees or restrictions.
The Freedom to Choose
With most health sharing plans, you can visit top-tier specialists or seek second opinions without worrying about out-of-network fees.
This freedom is essential for receiving optimal care, especially for complex medical conditions. You can go wherever you believe you’ll receive the best treatment.
This is very different from traditional insurance-managed care models, where getting approved for coverage at top-tier clinics, hospitals, or with top specialists can be difficult or impossible.
Financial Benefits
Health sharing plans are generally more cost-effective than traditional insurance, without sacrificing the quality of care.
The absence of middlemen like insurance companies keeps administrative costs low, allowing more of your money to go directly towards healthcare services.
While every individual and family is different, health sharing plans routinely save up to 50% compared to the unsubsidized cost of a traditional health insurance policy.
Take the Next Step to Escape Narrow Networks
If you’re tired of limited choices and want the freedom to choose your own doctors, now is the time to take action.
Whether you go with an HSA, a health sharing plan, or both, you’re doing more than just selecting a financial option—you’re taking control of your healthcare decisions.
A Personal Benefits Manager can help you explore your options and find the best plan for your needs. Don’t settle for a system that puts restrictions on your care. Take charge of your health and break free from narrow networks today.
Ready to choose your own path? Contact a Personal Benefits Manager now and start your journey toward true healthcare independence.
Here are some additional articles on healthsharing programs:
- Getting Disenrolled from Medicaid? Here’s What To Do
- Unraveling Healthcare Sharing Ministries: Faith-Based and Secular HealthShare Options
- How to Avoid Out-of-Network Fees
- How to Protect Yourself Against Doctor Scams
Here are some additional pages related to this article:
Compare Pricing on the Best HealthShare Plans Available
Healthcare Narrow Networks FAQs
What is a Health Savings Account (HSA)?
A Health Savings Account (HSA) is a tax-advantaged account that allows you to set aside money for medical expenses, including the option to choose your healthcare providers. It empowers you to take charge of your healthcare choices, free from the constraints of network limitations.
How does an HSA help me choose my own doctor?
An HSA offers the flexibility to use your pre-tax funds to pay for healthcare services from any provider, be it within or outside a traditional insurance network. This flexibility enables you to choose doctors based on quality and compatibility rather than network restrictions.
What is Health Sharing?
Health Sharing is a cooperative financial model where members share the cost of healthcare expenses. Unlike traditional insurance plans, health sharing plans often don’t restrict you to a network, allowing you to choose your own healthcare providers.
Can I visit any doctor with a health sharing plan?
In most health sharing plans, you have the freedom to visit any doctor or healthcare provider of your choice. You’re not bound by a limited network, giving you the autonomy to seek care where you see fit.
How do HSAs and health sharing plans differ from traditional insurance?
Traditional insurance plans often restrict you to a network of approved providers. Both HSAs and health sharing plans break this mold, offering you the freedom to choose any healthcare provider, without worrying about “out-of-network” fees.
Are there financial benefits to choosing HSAs or health sharing plans?
Yes, both options often come with financial benefits. HSAs offer tax advantages, and health sharing plans are generally less expensive than traditional insurance. The money saved can then be used to seek quality healthcare.
How do health sharing plans handle pre-existing conditions?
Health sharing plans may have specific guidelines for pre-existing conditions, such as waiting periods or limited coverage. It’s crucial to consult your plan’s terms to understand how pre-existing conditions are treated.
Are there waiting periods for surgeries in health sharing plans?
Waiting periods for surgeries can vary between health sharing plans. Some might require a waiting period for elective surgeries but cover emergency procedures immediately. Make sure to consult the guidelines of your chosen plan.
How do I choose the best health sharing plan for my needs?
When selecting a health sharing plan, consider factors like monthly share amounts, individual versus family coverage, waiting periods for pre-existing conditions, and whether the plan aligns with your healthcare values. Consult a Personal Benefits Manager for expert advice tailored to your needs.
Can I combine an HSA and a health sharing plan?
While HSAs are generally tied to High Deductible Health Plans (HDHPs), some people use their HSA funds in conjunction with a health sharing plan for maximum flexibility.
Can I contribute to an HSA if I’m part of a health sharing plan?
You can only contribute to an HSA if you are enrolled in a qualified High Deductible Health Plan (HDHP). Health sharing plans are not considered HDHPs by IRS standards.
Do health sharing plans offer any tax benefits like HSAs?
No, health sharing contributions are not pre-tax. However, they are often more affordable than traditional insurance premiums, even without the tax benefits, making them a cost-effective option for many. Especially those who don’t qualify for a big subsidy under the Affordable Care Act.
Is there an age limit for participating in HSAs or health sharing plans?
There’s no age limit for participating in health sharing plans. However, you cannot contribute to an HSA once you enroll in Medicare, typically at age 65.
You can, however, enroll in a healthsharing plan specifically designed for Medicare patients – the Medi-Share 65+ health sharing plan.
Are there any quality checks for healthcare providers in health sharing plans?
Since health sharing plans usually do not limit you to a specific network, they also do not perform quality checks on healthcare providers. It’s up to you to research and choose high-quality healthcare services.
Are health sharing plans and HSAs compliant with the Affordable Care Act (ACA)?
HSAs are compliant with the ACA. Health sharing plans are not insurance and are not required to comply with the ACA, but they may serve as an exemption from the mandate to have health insurance.
For more information on health sharing plans and HSAs, consult a Personal Benefits Manager to make an informed decision tailored to your healthcare needs.
