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No-Network/Reference-Based Pricing “Insurance” Plans

Valley Health wants to alert you to some recent and emerging industry practices that are causing confusion and frustration for employers and patients. Over the past few years, a number of third-party vendors referred to as “Reference-Based” or “No-Network” plans have begun selling products and services to individuals and employers. These plans do not provide the same financial protection that insurance does; however, they are being marketed to employers as an opportunity to reduce health care costs.

In some cases, these plans may cover physician office visits under a network arrangement that does not include hospital care, creating a false sense of security and leaving the patient at risk when hospital-based treatment or emergency care is necessary. Unfortunately, the sales pitch for these plans can be misleading or gloss over the shortcomings that leave patients vulnerable to far greater out-of-pocket costs and non-covered expenses than indicated in these plans’ marketing material. This is a scenario we want to help you avoid.

If you have any questions regarding your insurance plan’s coverage and benefits, the plan’s participation status with Valley Health, or if you are considering changing insurance plans and would like to verify a potentially new insurance plan’s participation status with Valley Health hospitals and providers, please contact our Managed Care team’s information line at 540-536-6140 or managedcare@valleyhealthlink.com. Although we cannot advocate any particular health insurance plan, we can answer questions regarding coverage to help ensure you, your employees, and their families have the level of coverage you believe you are purchasing.

Click here to read the entire message from Mark H. Merrill, Valley Health President and CEO, and Matthew T. Toomey, Vice President, Patient Financial Services, regarding these Reference-Based or No-Network plans.

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