Your health care needs are complex, and so is our national system of providing care.
As more and more people nationwide, including many Tennesseans, have become consumers of health care through the Affordable Care Act and the Marketplace Exchange, we’ve all had to learn how to become advocates for our own health through making knowledgeable decisions about how and where we receive care.
BlueCross is a partner in helping members navigate the complexities of today’s health care, while keeping your quality of care high and costs manageable.
In larger metropolitan areas of the state, narrow networks are one way to focus on a few high-quality providers to offer care to participating members, negotiating rates with these providers to keep patients’ costs low. Members who take advantage of narrow networks benefit from the lowest cost option insurance providers can offer.
Narrow networks offer high-quality care at a lower cost than broader networks, and those who join value price over choice. An important part of making the decision is understanding which providers are in your network. This is the lowest-cost option of network plans in the state. However, keep in mind that if you have a trusted hospital or a longtime primary care provider you want to continue seeing, you must determine on the front end that your facility or provider is in-network.
These networks typically are available in only major metropolitan areas. BlueCross’ narrow network – Blue Network E – is available in Chattanooga, Knoxville, Memphis and Nashville only, and one major health system in each city is considered to be in-network for those who choose our narrow network option. In Nashville, that system is St. Thomas Health.
Factor in your entire medical team. Keep in mind that larger procedures may involve more medical staff than just your provider or specialist who you may have previously determined to be in-network. Ask questions. Determine with your doctor that all staff, including anesthesiologists, etc., also are in-network to avoid surprises.
In-network for your insurer, but not in the narrow network … Remember that even if a provider or facility is in one of your insurer’s broader networks, for example, BlueCross’ Network P or S, you will pay more for your care if you see that provider. This applies even in emergency situations.
Out-of-network … You can use out-of-network providers and facilities. Just keep in mind that you will pay a higher price, and your insurance provider will pay less. You will be charged the difference for what your plan pays and what the provider charges.
Depending on your family’s and your individual health and wellness needs, a narrow network could be the right option. Know your network, and you will be one step closer to better long-term health and wellness with manageable costs.