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Posted by on Dec 31, 2013 in Colorado, Hawaii, Maryland, Nevada, Uncategorized, Washington | 0 comments

See your health plan’s provider directory on HealthCare.gov

HealthCare.gov has a new provider directory feature available to consumers shopping for health insurance; however, you can’t actually view a health plan’s provider directory from the exchange website.

While a handful of state operated exchanges (like those in Colorado, Hawaii, Maryland, Nevada, and Washington) offer consumers tools to easily determine if a doctor or hospital is in-network for a specific health plan; many states don’t have such provider search tools available as a consumer resource, including those states utilizing the federal exchange website, HealthCare.gov. In fact, until recently, consumers using HealthCare.gov had no easy way to determine which providers were in a specific plan’s network via the federal health insurance exchange.

HealthCare.gov-ProviderDirectory

Source: HealthCare.gov
Plan Details Direct Consumers to Provider Directory

However, this is changing, at least a little bit. CMS recently (December 2013) released a publication,What You Should Know About Seeing Your Doctor,” which helps consumers answer an important questions, “Does my new insurance plan cover my doctor?”

This publication states that, among the options for determining if your doctors and health care providers are covered by a Marketplace plan (like visiting the plan’s website and viewing the provider directory or calling the insurer or your provider directly), you can now “See your health plan’s provider directory on HealthCare.gov.” HealthCare.gov allows those browsing plans to view plan details. Included in those details is a link to the plan’s “Provider Directory,” which actually directs you to the health plan’s website. If you are lucky,  you will be directed to the provider directory that is utilized by a specific plan; otherwise, good luck determining which product or network a specific plan utilizes (this can be a pretty tricky task).

The provider directory link now available in the plan details is not an ideal solution for consumers trying to determine if their doctor will be in-network; however, it is a small step forward for HealthCare.gov in making shopping for health insurance easier for consumers. Maybe, those looking for health insurance through the federal health insurance exchange will eventually have access to a provider search feature that allows them to view providers directly from the exchange website; maybe the tool could even allow them to search for plans based on their provider needs!

Follow this blog to receive updates about health insurance exchanges.

Jillian Carlile
Research Analyst & Health Exchange know-it-all
Strenuus
jcarlile@strenuus.com

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Strenuus® is the industry leader in delivering network competitive intelligence services. We are the largest collector of managed care data in the country. With a singular focus on the managed care industry, we provide services to support payors, brokers, consultants and healthcare IT companies. Whether you represent employer-based coverage, Medicare, Medicaid, dental, work comp or specialty networks, we have the data and insights you need.

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