Wednesday, December 11, 2013

Covered California Unveils Robust Network Coverage for 2014

Data Show That Exchange Enrollees Will Get to Choose From More than 80 Percent of California Physicians

SACRAMENTO, Calif. — Covered California™ health insurance plans will offer a broad mix of physicians and hospitals when coverage starts in 2014, according to updated numbers released by the state’s health benefit exchange.



Through the 11 Covered California individual market health insurance companies, consumers will be able to choose from thousands of physicians, hospitals, community clinics, health centers and other providers. In fact, the vast majority, more than 80 percent, of the state’s practicing physicians are included in the exchange, and a substantial majority of California’s hospitals are available.

“We are confident that we are giving consumers extremely broad choices with the physicians, hospitals and networks in our plans,” said Covered California Executive Director Peter V. Lee. “We believe our offerings compare favorably to commercial networks in the state in the individual and employer markets. Covered California is bringing consumers health insurance options that not only fit their budgets, but also will meet their medical needs.”

The network composition has been a dynamic process since Covered California’s original solicitation of interested health insurance companies in March. Ensuring that every health insurance plan offered by Covered California would have adequate networks was a key element of the final selection process for those plans included in the marketplace.


More than 58,000 physicians are available through Covered California plans, a number that compares favorably to the 63,000 to 72,000 physicians in the state’s largest commercial networks.

There are also more than 360 hospitals available through Covered California plans, with nearly two-thirds meeting the federal definition of “essential community provider,” or those that serve low-income or previously uninsured populations. Available facilities through one or more Covered California plan include all member hospitals of the California Children’s Hospital Association, as well as leading academic and research health care organizations. The California Office of Statewide Health Planning and Development lists 365 general acute-care hospitals in California.

Exchange officials said the data underscored the importance of consumers making informed choices as they select health insurance plans through Covered California.

“We are proud of the insurance options we are bringing consumers,” Lee said. “We also have contingency plans requiring health plans to expand their networks if needed. Our core job is to be sure insured Californians get the care they need, and we will continue to monitor the plans so they have enough qualified providers to deliver that care.”

About Covered California
Covered California is the state’s marketplace for the federal Patient Protection and Affordable Care Act. Covered California, in partnership with the California Department of Health Care Services, was charged with creating a new health insurance marketplace in which individuals and small businesses can get access to affordable health insurance plans. With coverage starting in 2014, Covered California helps individuals determine whether they are eligible for premium assistance that is available on a sliding-scale basis to reduce insurance costs or whether they are eligible for low-cost or no-cost Medi-Cal. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Small businesses can purchase competitively priced health insurance plans and offer their employees the ability to choose from an array of plans and may qualify for federal tax credits.

Covered California is an independent part of the state government whose job is to make the new market work for California’s consumers. It is overseen by a five-member board appointed by the Governor and the Legislature. For more information on Covered California, please visit www.CoveredCA.com.