Your Source for Health Reform

Topic: Network Adequacy



The extent to which a health insurance plan comprehensively meets the health care needs of its enrollees. A health plan with a satisfactory number of doctors, specialists and suppliers—all within a reasonable traveling distance to its enrollees— is considered adequate. To ensure a prospective health plan will address all their medical needs, consumers need to double check the plan’s network.


Network Adequacy Analysis

This December 2015 report from the Aids Foundation of Chicago analyzes Illinois silver-level Marketplace plans’ coverage of HIV and the Hepatitis C Virus treatment. The trend has been for Marketplace plans to limit coverage of necessary treatments for this population.

Shop to Renew During Open Enrollment

This October 2015 blog post from the Center on Health Insurance Reforms explains the importance of exploring health insurance options when keeping coverage during the general enrollment period.

5 Pointers for Marketplace Shoppers

This October 2015 explainer from the Commonwealth Fund shares tips for consumers to consider when exploring their health coverage options during Open Enrollment number three.

Stop, Shop, Enroll!

This October 2015 infographic from Families USA tells consumers the steps to find the best health insurance plan during Open Enrollment number three.

Know Health Insurance Lingo

This September 2015 guide from Families USA  explains many of the health insurance terms that consumers need to understand when they are shopping for insurance.

Health Insurance Vocab

This July 2015 fact sheet from Health & Disability Advocates defines important health insurance terms. Community organizations and brokers can share with the newly insured.

Network Adequacy Can Impact Quality of Care

Although enrolling in a health insurance plan is important, the medical options available through a plan can also impact an individual’s ability to access care and stay healthy. Network adequacy refers to the quality and quantity of healthcare choices that a person has within a certain plan. This October 2014 explainer from Families USA summarizes the basics of network adequacy and details how it can impact individuals trying to get care through their health plans – all in just six slides.