How Paytient Pairs Well With Narrow and Broad Networks

Do you have any idea whether your health insurance plan falls under a narrow or broad network? It’s not always explicitly mentioned by insurance companies, but it’s crucial for members to be aware.

Understanding Wide Network Health Plans

When people think of employer-sponsored insurance plans, they often picture wide networks. These plans typically offer a broad range of primary care physicians, specialists, and hospitals in the area.

Reading: What is broad network insurance

Narrowing Down Narrow Network Health Plans

As the name suggests, narrow networks have more limited coverage and include a smaller selection of local providers. However, the degree of narrowness can vary significantly across different providers. Generally, while a broad network plan may encompass around 70% of providers in the area, a narrow network plan may only include 10% to 25% of them.

Many insurance providers have started introducing narrow network plans as a cost control measure. They collaborate with healthcare providers willing to accept lower fees in exchange for a higher volume of patients. These savings are then passed on to plan members and their employers through lower premiums.

Although narrow network plans have been prevalent among self-insured individuals since the Affordable Care Act was enacted, they haven’t been as common for those receiving insurance through their employers. However, due to the escalating premiums, narrow-network plans are gaining popularity among group buyers as a more affordable alternative to traditional wide-network health insurance. Now, let’s delve into the factors that companies consider when selecting between these plans.

The Decision Dilemma: Narrow vs. Wide Networks

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Choosing between narrow and wide network health insurance boils down to two key factors: cost and access to care. While narrow networks tend to offer more affordable premiums (approximately 16% cheaper, according to one study), they come with a limited number of available care options for plan members.

But it’s a bit more complicated than that. If members on narrow network plans need to seek care outside of their networks, it can be significantly more expensive compared to being on a wide network plan.

This plays a major role in why narrow network plans are more cost-effective. Wide network health insurance typically covers some out-of-network providers through copay or coinsurance. In contrast, narrow network plans generally lack this coverage, making them more profitable for insurers.

Keep in mind that if your in-network options are limited, especially in rural areas with restricted access to specialty care, the likelihood of needing an out-of-network provider increases. This can make the decision of what to prioritize (cost or access to care) challenging, especially when deciding on behalf of a group. The same plan that saves one member money by reducing monthly premiums may subject another member to exorbitant costs through out-of-network providers.

Some employers opt to offer their employees both limited and wide network health insurance options. While this is usually more expensive for employers than solely providing a narrow network plan, it gives employees more flexibility to choose the plan that aligns best with their needs.

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It’s impossible to find a “perfect” plan that suits everyone in a group. The best approach is to provide options that allow plan members to customize their coverage and payment preferences.

Breaking Down Barriers to Care with Paytient

One way to offer such options is by providing paytient as a benefit. Paytient is a health plan and employer-sponsored benefit that grants members access to interest-free funds for medical, dental, vision, and even veterinary expenses. Members can use their payment cards to spread large healthcare costs into more manageable, interest-free payments at a pace that suits them.

If you choose to exclusively offer a narrow network plan to your members, paytient can act as a safety net, covering any out-of-pocket costs including deductibles, copays, coinsurance, and expenses associated with seeing out-of-network providers.

Even if you decide to go with wide network health insurance, paytient still provides peace of mind for members who can afford to pay for their care in full. Instead of paying a lump sum at the time of service, they can utilize paytient to spread those expenses over time and minimize the impact on their monthly budget.

The mission of paytient is to eliminate unnecessary financial hardships from the healthcare system. Whether you opt for a narrow or wide network plan, or even both, Paytient can help make the plan more accessible for your members. Rather than resorting to high-interest credit cards, payday loans, or other harmful methods of paying for care, plan members can rely on paytient to obtain the necessary treatment promptly and focus on their recovery.

Source: https://amajon.asia
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