When Michelle Mazzola’s young son Guy was diagnosed with autism, she urgently searched for in-network therapy providers—only to find most were unreachable, no longer accepting patients, or had months-long waitlists. She had stumbled upon what’s known as a ghost network—a health insurance directory full of outdated or inaccurate provider listings.
Ghost networks delay care, mislead patients, and often result in families paying out of pocket for services they thought were covered. Despite laws requiring insurance directories to be updated regularly, enforcement has been weak. Mazzola estimates she spends about $7,000 a month for her son’s therapy.
Class action lawsuits have been filed against insurers like Anthem and Carelon, accusing them of deceptive practices that misrepresent the availability of in-network care. In one case, a review found 20 out of 21 providers listed in Anthem’s directory were either unavailable or didn’t treat children Guy’s age.
Studies show this is a widespread issue. One analysis found 81% of listings in major insurance directories had incorrect information. Mental health providers are particularly affected; in New York, 86% of listed therapists were ghost entries.
Insurers say they try to maintain accurate listings, but experts say the system is broken. Some insiders allege that provider lists are inflated to meet network size requirements on paper. Meanwhile, families like the Mazzolas are left without the support they were promised.
Legal protections exist, including the No Surprises Act, which mandates regular directory updates and reimbursement for patients misled into out-of-network care. Yet penalties are rarely enforced.
Experts say better data systems or centralized directories could help, as could using AI to verify listings. But families like the Mazzolas believe more ethical accountability is needed.
“You pay for insurance hoping it’ll be there when you need it,” said Guy Mazzola Sr. “But that just wasn’t the case.”
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