I’ve seen a lot of articles and comments (elsewhere, not here) indicating a lot of confusion about “ACA plans” or “Obamacare plans”. With minor exception, all private insurance is now ACA compliant, irrespective of whether the plan is provided through an employer, purchased on a state or the federal insurance exchange, or purchased privately outside the exchanges. Effectively, ALL insurance is now an “ACA plan”.
In some states, some carriers have identical plans available both in and outside the exchange. And identical means identical, the exact same provider network. But there is no requirement that carriers offer identical plans off the exchange. In some states, carriers offer no off-exchange policies. And there is no requirement that provider networks be similar. Nothing about this is new. Big carriers like Anthem and Aetna have always had dozens of plans and each one had their unique provider network. Often providers will contract for some carrier plans but not others.[/quote]
Yes, you are very correct that all plans are now ACA compliant.
Someone correct me if I am wrong here, but I’ve read that if a provider network isn’t contracted to be offered through ACA, they also won’t be offered through private purchase directly outside ACA neither.
So this point you mention isn’t correct from what I’ve seen and have personally experienced first hand:
”
Big carriers like Anthem and Aetna have always had dozens of plans and each one had their unique provider network
”
I’ve read that the networks are the same whether it’s ACA or private purchase.
I don’t know about employer plans since that’s probably totally different.
My point being:
My kids wanted to use Sharp facilities via Anthem Blue Cross outside of ACA. Anthem isn’t contracted with Sharp currently so if you have Anthem, you can’t go to a Sharp Rees-Stealy Hospital/Medical facility (again, I don’t know about employer plans).
Maybe someone with Anthem Blue Cross (non-employer since I think that’s a totally different market) can state they HAVE been able to use Sharp Hospitals with Anthem…but when I called Anthem, they couldn’t find anyway to get that so we had to all switch…
Again, this is from my own real life experience as I was rejected actually AT the Sharp hospital so take it for what it’s worth.
