Any Willing Provider Laws

People choose to stick with one primary physician for a multitude of reasons. Unfortunately, if someone changes jobs and has to get a new health insurance plan, there is the chance that the new plan won’t list their current doctor in its network. This has often led to disgust and resentment of the healthcare system in general. Having to choose a new doctor from a list of unknowns is often tedious and confusing. Luckily, the rise of Any Willing Provider laws has begun to change how the system works.

An Any Willing Provider Law is a law passed in certain states that requires managed care organizations and medical insurance providers to allow their policyholders the leeway to seek medical help from whatever doctor they want. These laws require the chosen physician to agree to the terms and conditions that apply to network members of the health insurance plan, including the fee, but they also allow a patient to stay with whatever doctor they want.

While a person having the option of picking their own physician regardless of network ties seems like a fully beneficial idea, it does have some downfalls. A patient who gets all of their healthcare services provided by a doctor who is not in a health plan’s network will pay the same co-payment that is required of policyholders visiting in-network doctors. If an out of network doctor charges more than the plan’s coverage offers, however, the patient will be liable for the additional charges. This means a patient will sometimes have to pay extra to choose their own doctor.

Many people would welcome the additional payment that may be necessary to choose their own physician, but unfortunately for some of those people, Any Willing Provider laws do not exist in all states. Only about half of the states actually have these laws on the books, leaving the other half only the options provided them by their insurance provider.

Opponents of Any Willing Provider laws point out that it becomes more difficult for medical insurance plans to get volume discounts from doctors due to the inability to channel patients to specific physicians. They also say that having additional doctors using the plan makes it more difficult to coordinate with and monitor physicians. Proponents of the laws say that prices shouldn’t go up at all due to the fact that insurance plans reimburse out-of-network providers the same rates as in-network providers.

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