Topic Area:  

  • Provider networks and referrals

What should I consider when choosing a plan with a narrow network?

What are narrow network plans?

A narrow network plan refers to a health insurance plan with a smaller than usual, or "narrow," provider network. In a narrow network plan, health insurance companies try to lower costs by working with a smaller number of providers and fewer in-network facilities. Narrow network plans are offered by employers, through the Health Insurance Marketplace (www.HealthCare.gov), and in Medicare and Medicaid plans.

Why might you choose a narrow network?

The main benefit of a narrow network plan is that they are typically less expensive than plans with larger networks. Narrow network plans may offer lower premiums and out-of-pocket costs. Be sure to check that your current providers are in-network.

Are there any tradeoffs to consider?

Yes, there are tradeoffs to keep in mind if you are considering a health insurance plan with a narrow network.

In a narrow network, your access to providers is limited. You may have fewer choices or have to travel further to receive care, especially if you need to see a specialist.

If you know you will need specialty care, you should carefully check a plan's provider directory to find out if your current provider, or another provider of the specialty care you need is in the network. Even if you don't need specialty care now, you should check what types of care you will have access to in case you need it in the future.

Out-of-network services can be very expensive, and it is your responsibility to make sure that a doctor or care provider is in-network before you receive care.

Information about the provider networks of plans offered through New Hampshire's Federally Facilitated Health Insurance Marketplace can be found here: https://www.nh.gov/insurance/consumers/mp_plans.htm

4/19/2018