Consumer Protections in the Affordable Care Act

Access to Choice of Providers

For health plans that require enrollees to select a primary care provider, the ACA sets a new standard allowing enrollees to have a choice of any primary care provider accepting new patients in the plan's provider network. In other words, unless the enrollee neglects to select their primary care provider, the plan may not select one for the enrollee. In addition, if a child is enrolled in a plan that requires a primary care provider, the ACA gives enrollees the right to choose a pediatrician as their child's primary care provider. The law also guarantees direct access to in-network OB/GYNs for women in health plans that require them to designate primary care providers (in other words, not requiring prior authorization or a referral). 

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