Unveiling the Key Differences between Level Funded and Self Funded Plans
Discover the differences between level-funded and self-funded employee health insurance
You’ve already elected a plan for 2017—but you’re not covered yet. Understanding the cost of visiting a doctor out-of-network will save you thousands of dollars this year. Avoid the unnecessary stress of filing claims and know what doctors are participating in your network.
Most health insurance plans are going to have a group of physicians and hospitals that they are contracted with. Typically doctors are affiliated with a specific hospital. For those of us who have a hospital preference, pin pointing these hospital affiliations is a good way to narrow down your search. The best way to prevent having unexpected health care costs is to check which doctors are covered in your plan’s network. Carriers will cover a larger percentage of the costs when visiting a physician or hospital that is in-network, and will cover much less (sometimes nothing) if the doctor is out-of-network.
Note: Visiting an in-network hospital or other medical facility does not guarantee every practicing physician within that facility is contracted with your plan. It’s always good to get a second opinion in medicine, and it’s always good to double check who is in-network and who is not.
It’s always good to get a second opinion. Call your doctor and ask for the office manager—they have access to the updated list of insurance plans your doctor is accepting this year. When looking for a new doctor they are also the ones who can tell you if that doctor is accepting new patients. Deciding on a doctor can seem like a daunting decision. Remember, you’re never locked in. Patients change doctors every day and that’s okay.
Many people go out of network by accident.
For example: Your Primary Care Physician might refer you to an out-of-network specialist. Unless this is the only specialist who can treat you, kindly ask your PCP to refer you to in-network specialist only.
Rather than relying on a broad search engine or crossing your fingers. Allow us to point you in the right direction.
Discover the differences between level-funded and self-funded employee health insurance
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IXSolutions brings over 30 years of combined experience to the market as Employee Benefits Consultants. We’ve been bringing creative solutions and alternatives to the market since the inception of the Affordable Care Act.
Today, we work with companies, individuals, and Medicare eligible individuals to provide solutions to the complex insurance industry. We are a trusted partner to thousands of clients, brokers, and associations across the country.