Health insurance plans to be rated based on size of network

health insurance exchange

The Obama administration will now use the number of included doctors and hospitals in the ratings.

In response to complaints from consumers with respect to the way health insurance plans are rated on the exchanges, the Obama administration has now said that it will provide a rating for each plan based on the number of hospitals and doctors that are included within that plan’s network.

Equally, there will also be an increase to the maximum annual out-of-pocket amount that consumers can pay.

For individuals, the maximum out-of-pocket expenses for health insurance next year, will be $7,150. For families that figure will be $14,300. Consumer advocates haven’t been impressed with those numbers, as they have said these additional costs could pose a considerable financial burden for middle-income individuals and families who require a large amount of medical care. These new rules were published within the Federal Register, this week. Under these regulations, insurance companies will be able to sell health plans with limited provider networks.

Consumers will be able to identify those health insurance plans as they will have a special rating.

health insurance exchangeA new rating will be attached to the health plans in order to allow consumers to see exactly how large – or how small – the network is under the policies sold on the HealthCare.gov exchange. By January 31, approximately 12.7 million people had either enrolled or automatically renewed their coverage during the span of the third open enrollment period.

Several of the health plans sold over the insurance exchange included a restricted selection of hospitals and doctors. That said, some insurance companies further narrowed their networks by dropping popular teaching hospitals and creating exclusions for certain doctors. Many customers have not been impressed with those changes and some have stated that they are struggling to be able to find a specialist covered under their plan.

However, consumers who are looking for an opportunity to pay lower health insurance premiums have been choosing those limited network plans because they aren’t as expensive as those with a wider choice of hospitals and doctors. The latest rating changes on the exchange will make sure that consumers will be making an informed choice before they select their next plans.

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