Provider Network Adequacy

Provider Network Adequacy

A network is a group of health care providers that health plan companies contract with to provide health care services to enrollees who purchase coverage. A health plan’s network includes providers that deliver primary care services, mental health services, general hospital services, specialty physician services, ancillary services, specialized hospital services, and other health services. Enrollees often receive the most coverage at the lowest cost when they use a provider in their network.

The Managed Care Systems Section is responsible for certifying provider networks including physicians, specialists, clinics, hospitals, and other providers. In Minnesota the provider networks of health plan companies must meet geographic access standards and include a sufficient number and type of providers to ensure that covered services are available to all enrollees without unreasonable delay.

For more information on topics related to provider networks, click on the links below:

To find out more information about the health care provider networks and the service areas for health plans offered on MNsure in 2019, see 2019 MNsure Provider Networks and Service Areas.

Updated Wednesday, October 03, 2018 at 07:35AM