Closed Access - Health Insurance Definition
Some insurance plans have a provision
called, “Closed Access.” This means
that there is a list of health care providers
and that you must utilize the services of doctors,
pharmacies, hospitals and clinics on that list
in order to receive the heal care benefits you’re
paying for. In most cases, the insurance won’t
pay if you use the services of an out-of-network
doctor.
If you’re considering an insurance provider
that has this policy, be sure that you look over
their list. In most cases, these lists will include
many of the health care professionals in your
area. It’s not uncommon to discover that
your current physician is on the list and that
you wouldn’t be required to make any changes
in order to file an insurance claim.
However, even if your doctor is on their list,
there are some questions you should ask.
The biggest is what provisions are offered for
emergencies that occur away from home? If you’re
visiting your parents three hundred miles away
and have an allergic reaction to the shrimp egg
rolls, will you be paying the cost of your emergency
room visit because that hospital isn’t on
your insurance company’s list? Most have
some provisions for this occurrence, but take
time to be certain.
Another important question is how many health
care professionals around the country are on the
list. For example, if you move to another state,
are there lots of doctors there or will you then
be shopping for a new insurance company? Ask your
broker
to fully explain the policy and consider your
options carefully. |
