TitleWeb
New IBC products available through the Health Insurance Marketplace
Professional; Facility; Ancillary
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As mandated by the Patient Protection and Affordable Care Act of 2010, each
state is required to establish a Health Insurance Marketplace by January 1,
2014. Health Insurance Marketplaces are a new way for certain consumers to buy
health insurance. They will offer a choice of different health plans for those
who buy their own individual and/or small group coverage, certify health plans
that participate, and provide information to help consumers better understand
their health coverage options. IBC will participate in the federally
facilitated Health Insurance Marketplace for Pennsylvania by providing various
commercial products that are covered under your current Professional Provider
Agreement and will be reimbursed in accordance with your payment rates for
commercial products.
These commercial products will be available beginning January 1, 2014, and will
include tiered provider network products. These tiered network products will
have benefit designs with different member cost-sharing by tier and will offer
members a lower out-of-pocket cost (e.g., copayment) when they select a
provider in the preferred benefit tier. The following provider types will be
designated to one of three tiers: primary care physicians, specialists, acute
care hospitals, home health, sleep study centers, dialysis centers, and
ambulatory surgical centers. To the extent applicable, these providers will
receive a letter in August notifying them of their tier assignment.
Look for more information about these new products in future editions of
Partners in Health UpdateSM.