Your network

One easy way to save money on health care is to know your network and to only use doctors who are in your network.

What's the general bottom line?

  • In network = cheaper for you
  • Out of network = more costly for you

Why does my network matter to me?

A network is a group of doctors, clinics and other health care providers who have worked with us to set special prices just for you. When a health care provider is in your network, it's called "in network." Your plan is an Exclusive Provider Organization plan, which means that you are only covered at in-network providers and facilities. There is no out-of-network coverage except for emergencies.

Your network is printed at the top rightHow do I find out what my network is?

Pull out your member ID card and take a look. Your network is printed at the top right. Or you can sign in and find it on your Member dashboard.

How do I know if a provider is in my network?

If a provider accepts my insurance, it's in network—or is it?

A provider may take your insurance but be out-of-network. Instead of asking your doctor, "Do you take my insurance?" make sure that they are part of your network.

The smart bet is to know before you go. Find out if the doctor or clinic you want to visit is in your network before you make an appointment or walk through the door.

Tip: If your doctor or clinic refers you to another provider for specialty care, check first to make sure that provider is part of your network.

Note: Make sure all your care is provided by in-network providers. If you receive care from an out-of-network provider, even if you are in an in-network facility and/or other providers treating you are in-network, you may have additional costs. Except as prohibited by law, these additional costs may include higher cost-sharing (such as any applicable out-of-network deductibles, coinsurance, copays, or out-of-pocket maximums), as well as responsibility for balance billing (that is, for the difference between the out-of-network provider's charge and our allowed amount). Also, the additional costs may not count toward any in-network out-of-pocket maximum in your plan. Review your policy or benefit booklet for details about coverage of out-of-network care.

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