Our guide to limited networks

Limited network plans are becoming increasingly popular health care options among employers and consumers. Learn about how limited networks work – including our own – below.

What is a limited network?

Limited networks, also called narrow networks or high-performance networks, offer consumers a limited choice of high-quality healthcare providers within a specific service area in exchange for lower premiums. There’s no strict definition for how many providers are in a limited network plan, but plans often have 25% or less of local providers participating. By contrast, broad network plans often have up to 70% of local providers participating. Despite having fewer choices, limited network plans are much less expensive than broader network plans, and this trade-off appeals to many consumers. Limited networks can be particularly beneficial for those who are young, healthy, and live in the primary service area of the network. Even with fewer participating providers, limited networks still offer a high level of care.

According to The New York Times, nearly half of the plans offered on public health care exchanges this year are limited network options. Nearly a fifth of these plans are considered “ultranarrow networks,” offering even fewer choices than a standard limited network. These plans are proving popular with employers as well, mainly as a way to reduce health care costs. In KFF’s 2018 Employer Health Benefits survey, 18% of companies with 5,000 or more workers said they offer at least one limited network plan. 10% of companies with 1,000 or more workers offer the same.

Allies HMO and Select HMO

AllWays Health Partners has developed products to give employers and members the opportunity to choose limited network plans and the benefits that come with them. Our Allies HMO product, made in partnership with Newton-Wellesley Hospital, isn’t your typical limited network plan. This innovative product is designed to make high-quality care more affordable and accessible for employers and members, offering access to top-quality hospitals and providers. Find more information on Allies on our website.

In 2021, AllWays Health Partners will launch a new limited network product that will have access to the Select HMO network. This product will be available through the MA Health Connector, including to ConnectorCare members. Through the limited network, employers and members in 8 eastern MA counties will have access to comprehensive benefits and high-quality providers at a lower cost.

You may have already received a notice indicating that you will be a part of the Select HMO network, in which case there’s nothing more you need to do to start seeing Select Network members in 2021. If you’re wondering who else is a part of the network, AllWays Health Partners’ online provider directory has been updated to display Select HMO network providers. There won’t be any changes to covered services, benefits, or authorization/referral requirements if you are part of the network.

We’ll be offering more information about the Select HMO network before it’s available to members, including training opportunities for you to learn more. To stay informed, make sure you’re subscribed to Best Practice as well as our other communications. You can also check out our Select Network FAQ. More information is coming, so stay tuned!

To learn more about all of our products, visit our product page.