What is fair-priced healthcare?
January 21, 2025
Fair-price healthcare is a no-network, proactive pricing strategy that relies on a care coordination team to match members with providers that work best with their plan.
If your health plan uses fair-priced healthcare, it will try to determine what the most fair price is for a service in any given area by examining average prices, cash prices, or using other reference points, such as the Medicare rates.
Why use fair-priced healthcare?
Typically, prices can vary dramatically depending on the provider or facility—even in the same area. Your health plan uses a fair-priced healthcare approach to ensure your plan pays a reasonable rate rather than accepting unnecessarily inflated costs.
This healthcare pricing strategy improves transparency for both plan sponsors and members alike, allowing both groups to benefit from fair prices for healthcare services.
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Learn More
- Download this helpful flyer about how fair-priced healthcare works with most Planstin-managed health plans.
- Read about your right to pick your provider here.
Explore
Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
Preventive Core is a health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Core health plan, click here and select your specific plan name.
All Planstin-managed health plans now feature care coordination services as a part of a fair-price healthcare strategy. The Planstin Care Coordination team will help match members with providers that work best with their plan.