Jefferson Community Health & Life encourages everyone to know their health insurance plan – and check carefully into what coverage is available when choosing a plan.
“We are seeing more patients recently being disappointed because JCH&L is not in the network for their health insurance plan,” said Kim Shadduck, JCH&L business office manager. “Often the issue is that we are contracted with the company but not their particular plan.”
Shadduck said that every carrier has a wide variety of plans available. Some plans are “narrow network” plans, meaning they cover only a specific group of hospitals or providers – and those providers may not even be in our state. Some are specific to virtual visits with specific providers. She said when considering plans, be sure to ask which health care facilities and providers are covered as a part of the plan, and whether you can continue to use your chosen health care provider and home town clinic and hospital services. She said sometimes a plan may cover only Emergency Room visits when out of network, and the patient may or may not have to meet a deductible or pay a copay on that.
Some things to pay extra attention to when shopping for new insurance are: Is this a new plan offered by the company? Does the plan name contain any key words that may indicate a narrow network, like the name of a hospital/group or words like Virtual or Region or the name of a state? Then be ready to ask questions or do more online research about what that means. If shopping on the healthcare.gov market place, check on whether the facilities and providers you may want to use are covered as part of the plan.
The JCH&L business office welcomes calls and questions about whether we are “in-network” for specific plans – but please be sure to ask about the specific plan. JCH&L may be in network with the company, but not every plan the company sells, Shadduck said.