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As health insurance networks get skinnier, consumers must get savvier: 2015 Health Insurance Guide

The Oregonian
By Nick Budnick
November 07, 2014

Matt Mastrantuono, 28, describes himself as "someone who uses their health insurance more than they want to."

But the self-employed Portland filmmaker thought he was good to go when open enrollment closed for 2014. He'd purchased a Health Net policy for $237 a month that featured a mere $100 deductible before coverage kicks in and a $1,000 cap on his out-of-pocket expenses.

Laura Cali, Oregon's Insurance Commissioner, oversees insurance companies in a chaotic time for health coverage. Shown in Northeast Portland on Oct. 31, she is leading discussions with insurers to increase consumer access to information about health plan networks, which are getting increasingly narrow and restricted as the federal health care law takes hold. (Mark Graves / The Oregonian)

Laura Cali, Oregon's Insurance Commissioner, oversees insurance companies in a chaotic time for health coverage. Shown in Northeast Portland on Oct. 31, she is leading discussions with insurers to increase consumer access to information about health plan networks, which are getting increasingly narrow and restricted as the federal health care law takes hold. (Mark Graves / The Oregonian)

When Mastrantuono was preparing to see a specialist at Oregon Health & Science University, however, he realized OHSU was not part of his new plan's network. OHSU does accept Health Net, but only certain of its plans — and not his.

The "community care" plan he'd purchased places strict limits on which providers you can use. But open enrollment was over, so he couldn't change plans until 2015.

"I was essentially locked in for another six months," he said.

Mastrantuono's experience shows the new uncertainties in today's insurance world, said Jesse O'Brien, a consumer advocate who tracks health insurance for The OSPIRG Foundation. He says it's no longer enough to only ask your provider, "Do you take Health Net?"

Insurers are increasingly using narrow or "skinny" networks to keep costs down, allowing them to offer lower premiums in the new, highly competitive world of the individual and business markets.

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