What is true regarding plans with narrow or select networks?

Plans with narrow or select networks often have arrangements that limit the range of specialists available to members. This is mainly due to the agreements that the primary care physician (PCP) has with specific specialists within an Independent Practice Association (IPA) or medical group. When a plan operates with a narrow network, it typically means that to manage costs and ensure coordinated care, the plan incentivizes members to receive services from a designated group of providers.

By limiting the specialists to those who are contracted within that network, the plan can effectively manage the quality of care and costs associated with treatments. This structure helps streamline patient referrals and can often lead to a more cohesive care experience. Thus, members are encouraged, or sometimes required, to utilize specialists within this limited network to receive the full benefits of their health plan without incurring higher costs.

In contrast, options that suggest broad access to any specialist or hospital do not align with the design and cost management intentions of narrow or select network plans.