Transparency in Coverage
Health plan price transparency is intended to help consumers know the cost of a covered item or service before they receive care. Per a new Transparency in Coverage Rule, Group health plans are now required to disclose in-network rates and out-of-network allowed amounts. Below is a link to the required machine-readable file available to comply with the rule at this time:
While consumers will be unable to use the data in this file at this point due to the complexity and algorithms required to interpret the data, future expansions to this rule will make the data more accessible to consumers. This will include internet-based price comparison tools which will allow an individual to receive an estimate of their cost-sharing responsibility for a specific service from a specific provider.
Watch this page for more details in 2023 and 2024.