When it comes to something as important in life as medical insurance, change can be scary, but that doesn’t necessarily mean a change is bad. While network-free insurance is new, this new approach to medical insurance is rapidly gaining traction as a more beneficial option. A direct relationship between the patient, their medical providers and their medical insurance is a true advantage.
For policyholders who have only ever held PPO network-style insurance plans or benefits, the idea of open access insurance can be unfamiliar. Further, transitioning from a traditional carrier to a totally new form of provider access can seem intimidating. However, network-free medical insurance brings a host of advantages and more freedom with healthcare choices.
Open Access Insurance Plans Don’t Have Typical Network Limitations
With a typical network-style insurance plan, policyholders are accustomed to having a list of in-network healthcare providers or a PPO network that they can go to in order to get care. All insurance networks have disruptions or providers within the area that do not participate with the specific insurance company. For example, some doctors may not work with Aetna, Anthem Blue Cross Blue Shield, United Healthcare or Cigna. This means that enrollees may be left paying higher out-of-network costs or seeking care from a second-choice provider simply because that provider is not in the network.
Alternatively, an open-access program does not have these limitations. For example, the ClearChain Health Program is designed to allow members to access healthcare at any provider as long as the provider confirms participation with ClearChain Health.
Care Providers Only Have to Confirm Participation with the Insurer
With no network, members have the freedom to work with their preferred healthcare provider instead of being at the mercy of a predetermined list of providers. Nationally, ClearChain Health has found that 95 percent of providers will participate with ClearChain Health when introduced because of ClearChain Health’s fair payment model and the process works much the same as it does with traditional coverage:
- Provider provides care for the member
- Provider bills ClearChain Health
- ClearChain Health pays the provider
- ClearChain Health sends an Explanation of Benefits to the provider and member
- Member pays their patient responsibility
If a member plans to see a certain provider, they can simply nominate that provider through ClearChain Health, ClearChain Health reaches out to the provider to review the program, the provider confirms participation, and then the member can proceed with their visit. As noted, the vast majority of healthcare providers will work with ClearChain Health
Removing a PPO Network Offers a List of Advantages for Employees and Employers
For employees, the advantages don’t end with open access to just about any healthcare provider. Some of the additional benefits of a direct relationship between patients, their medical providers and their insurance plan can include:
- Lower employee-paid contributions
- Lower out-of-pocket costs
- Significant reduction in cost liability
- Zero cost generic medications
- Zero co-pay costs for kids
Advantages go beyond the member side of the equation with open-access medical plans. As of 2019, the average employer paid $5,483 annually per employee insured with traditional medical insurance. However, ClearChain Health has found that employers who switched to their open-access plans save between 25 and 40 percent within the first year of switching. One thing companies like ClearChain Health offer that traditional carriers don’t is transparent pricing models. Instead of confusing fee models with hidden reimbursements and rebates, transparent health plans not only reduce costs but demonstrate higher levels of accountability without any hidden fees.
ClearChain Health Open Access Medical Insurance Could Be the Future
While open access, network-free medical insurance is a relatively new idea, these programs could hold a large portion of the market in medical insurance in the coming years. Straightforward insurance options that save the company and the employee money and offer coverage flexibility have ample benefits for everyone involved. To find out more about open-access health insurance through ClearChain Health, take a look at our Member FAQ area.