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What to Know About Health Options’ Tiered Provider Networks in Individual/Family Plans

Oct 05, 2021
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The year ahead comes with a few changes to Health Options’ health insurance plans – and it’s all good news. One change we are excited to announce is a new tiered provider network option available in select individual/family Health Maintenance Organization (HMO) plans. While tiered plans may be new to Health Options, they are not new to health insurance. In fact, they are a proven way to save money on medical expenses. Read on to learn what tiering means to insurance plans and what it means to you as a health insurance consumer.

Tiered provider networks are a way to better manage the costs of healthcare services. They also provide health insurance consumers a better way to consider the cost of care when choosing their care options. Plans featuring tiered provider networks generally combine quality and cost in developing a preferred tier. Providers with high-quality outcomes and lower contracted prices are typically placed in the most preferred tier rankings.

As a consumer, you may wonder how Health Options decides which providers are considered part of our preferred tier. It is important to note, that all providers meet our quality standards, which is why they are part of the Health Options network. For tiered providers, we review claims history to analyze the quality of provider outcomes combined with their contracted cost and efficiency. Providers and facilities that meet or exceed our standards for quality, cost, and efficiency are “preferred,” and others are “standard.” 

To take advantage of tiered providers, you will need to select an individual/family plan with a tiered network option, which is available in both bronze and silver metal level plans for 2022. It’s important to note, that on a tiered plan, you always have the option to visit standard providers with a standard co-pay. 

As we enter the Open Enrollment season for 2022, we are proud to offer the highest quality healthcare at the best possible value with all our plans, and our new tiered network offers additional savings. If you have questions about tiered network plans and want help finding the health insurance plan that best suits your needs, contact our Member Services team at (855) 624-6463.

SEE ALSO

Do you consider yourself a glass half empty or a glass half full type of person? It turns out that even if you are not inclined to see the glass half full, there are good reasons to try to turn your thinking around for better emotional health. More and more research confirms that learning or deepening compassion, optimism and resilience are all tied to better mental, emotional, and behavioral health. Healthwise has some great information about the ways that positive thinking can decrease stress and increase coping skills.


The first way to think positive is as easy as giving yourself a break. You know that voice in your head that wonders if you said something stupid in a meeting or gives you a hard time for skipping the gym? What if that voice was more inclined to pep talks than a bad cop? Information gathered by Healthwise finds that compassion toward yourself can actually help you feel more compassion and kindness toward others. Healthwise suggests celebrating little wins, like remembering the passcode to pay your utility bill. Or take a walk instead of kicking yourself for that bad phone interaction you had. For more ideas about easing up on yourself, search “self-compassion” in the Healthwise search bar.

Optimism, or positive thinking, takes a very similar approach to day-to-day interactions and experiences. According to Healthwise, realistic optimism doesn’t mean you see everything through rose-colored glasses, it just means you look at the "big picture"; see the good and the bad and then decide on a realistic expectation; think about what you can do to make things go as well as possible, and choose to focus on the positives, and on your strengths, as you go forward. For more great tips, type “optimism” into the Healthwise toolbar and watch the wealth of information appear!

Finally, the term resilience has been gaining traction over the past few years, and it can be seen as the next step in the practice of compassion and optimism. Resilience recognizes that, as much as we’d like to, we can't prevent stressful, unpleasant, and less than ideal experiences from happening, but what we can do is build up your ability to bounce back after a hardship, like another COVID-19 outbreak, for example.

Healthwise has a video full of ways to bounce back, from giving yourself a break with a favorite movie or letting off steam with friends, which might mean a skating party or a bonfire in the snow. The good news is, resilience can make you tougher when it comes to navigating the tough times, but it does not have to be tough to do! Search "resilience" at Healthwise for more ideas.