When evaluating the health insurance marketplace options available in the Nashville metropolitan area, you need to take a close look at Network differences between each carrier.
Tennessee Rating Area 4, which includes Cheatham, Davidson, Montgomery, Robertson, Rutherford, Sumner, Trousdale, Williamson and Wilson Counties has four insurance company options and six network options… and FYI this area of Tennessee has some of the lowest rates in the country.
The lowest cost plans are going to be with Blue Cross Blue Shield of Tennessee. Their lowest cost plans are in their smallest network, the E Network. Blue Cross Blue Shield of Tennessee also offers two other networks, the S Network and P Network. The major differences in these networks are listed below.
Acute Care Hospital service is based around Metropolitan Nashville General Hospital, St. Thomas Hospital (including Midtown, Spinal Center and West Campus) and Vanderbilt Children’s Hospital. All of these hospitals are also in the other two networks, S and P, but does not include access to Vanderbilt University Medical Center. The major difference between the E Network and the S Network is access to Vanderbilt University Medical Center, otherwise, the hospital options are very similar.
When it comes to specific types of providers, you will see a more smaller selection between E Network and S Network. For example, there are 479 Doctors in the E Network within 25 miles of ZIP code 37207 that practice Family Medicine. That same search in the S Network yielded 1,373 doctors, and In the P Network 1,402. As you can see there is a big gap between E and S, but almost 97% parity between P and S Networks. That same rule almost always applies to other types of specialists in the area as well.
The S Network, which is roughly 18% more expensive than the E Network, has a much more comprehensive network of specialists and primary care doctors, as well as access to Vanderbilt University Medical Center.
Additionally, you have access to Williamson Medical Center in Franklin, TN and Northcrest Medical Center in Springfield, TN in the Greater Nashville area.
The P Network is designed to capture any and every doctor and provider in the area. For that luxury you will pay roughly 16% more than the S Network premium for the same plan, and roughly 37% more for the same plan in the E Network.
Humana – Nashville PPOx
The next lowest cost carrier option is Humana, and their network has Vanderbilt University Medical Center and Children’s Hospital. For about 32% more than the Blue Cross E Network, you can have access to those hospitals and also Williamson Medical Center, Rolling Hills Hospital, Southern Hills Medical Center and a few more. St. Thomas and Nashville General are not in this network.
There is also a smaller selection of Specialists and Primary Care doctors, more closely related to the Blue Cross E Network, and for a higher price…
CIGNA is going to be priced higher than Humana and Blue Cross Blue Shield of Tennessee. This network is based on access to 4 hospitals, Nashville General Hospital, Vanderbilt Children’s Hospital, Select Specialty Hospital, and Kindred Hospital of Nashville.
This is going to be priced at roughly 39.5% more than the lowest cost silver plan with BCBST. This plan is going to be for someone with very particular requirements about which specialists that they see that may not be in any of the other three networks.
Assurant uses an Aetna network that has a comprehensive network of acute care hospitals, including Nashville General Hospital, St. Thomas Midtown, Kindred Hospital of Nashville and Vanderbilt Children’s, but it is priced too high to be a reasonable choice. It is roughly 72% higher than the lowest cost silver plan with BCBST. Also, Assurant has issued a statement that they will be leaving the individual health insurance market at the end of 2015, causing all of their participants to transition to new carriers for 2016.
In conclusion, it’s not all about price! Network access is very important when choosing a plan in the Nashville area.
Andrew Hetzler is the Chief Operating Officer of American Exchange. For a free consultation with a licensed agent call 1-888-995-1674 or email firstname.lastname@example.org. To contact Andrew directly, you can email him at email@example.com.