How do the HMO Proactive Plans and “Tiered Network” plans work?

Tiered or Narrow Network Plans: Under the Affordable Care Act, insurance carriers have introduced “tiered network”, or narrowed network plans. Keystone Proactive Plans have a ” 3 tiered” network of providers. Although each carrier has different types of networks and benefit levels, the plans have the same general concept, steering the members by giving them a choice of providers that offer medical services at a lower out of pocket expense. Choosing a more expensive provider or facility may cost the member more out of pocket costs. United Healthcare offers 3 tiers in their “Navigate” plans, and Aetna uses “Savings Plus” designated providers to split the provider network into “designated” or “non designated” participating… Read More

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