Private Payer Issues

The AAFP Private Sector Advocacy team represents family physicians’ interests to non-governmental agencies. We negotiate with insurance companies, employers, health plans, and more to help you get better work conditions.

We’re working to save you time and money with:

  • Better payment
  • Fairer contracts
  • Less administrative hassle

Information about Medicare Advantage Plans

Medicare.gov has general information(www.medicare.gov) on the Medicare Advantage (MA) program, along with related resources on coverage options in MA plans.

On average, Medicare beneficiaries will be able to choose among 19 MA plans in 2016; the total number of MA plans will reach 2001 in 2016. The premiums and out-of-pocket costs paid by enrollees vary by plan type, locale, and characteristics, such as relative breadth of the provider network and/or benefits.

Medicare beneficiaries will need to understand their MA plan choices and carefully select the plan that fits their needs.

Learn more about MA plans »(www.medicare.gov)

AAFP Letter to the FTC Opposing the Merger of National Insurers 

In response to the potential merger of national health insurers, the AAFP has sent a letter to the Federal Trade Commission urging the evaluation of consolidations that would limit consumer choice and decrease competition within the health insurance marketplace.

Joint Letter of Organizational Support for Model Legislation on Network Adequacy

The AAFP has signed a joint letter to state policymakers in support of model legislation that would serve as a template for revising state network adequacy standards, as it relates to narrow/high-value networks.

The AAFP is working to establish reasonable and meaningful standards for network adequacy, while still allowing for market flexibility and choice.

AAFP's Response to UnitedHealthcare's Narrowing Networks

The AAFP has sent letters to UnitedHealthcare (United), America's Health Insurance Plans (AHIP), and the Centers for Medicare & Medicaid Services (CMS).

These letters collectively voice concerns regarding United’s one-sided actions that disrupt patient-physician relationships and dictate to patients which doctor they are allowed to see with little to no input from the patients themselves.

The letters end with the desire to set up an ongoing dialogue to better understand the current state, determination, and effects of narrow or high-value networks.

Narrowed from a network?

We want to know. Complete a brief form to give us the details of your removal from an insurer’s provider network.

Take the Survey »

Having a problem with a payer?

Follow these steps:

  1. Contact the payer directly.
  2. Reach out to your local chapter for help.
  3. If the problem persists, contact the AAFP at (800) 274-2237.