Provider Access
Quality healthcare starts with access to the right providers. Our extensive network includes thousands of doctors, specialists, hospitals, and healthcare facilities across the nation, ensuring you can find care wherever you are.
Quality healthcare starts with access to the right providers. Our extensive network includes thousands of doctors, specialists, hospitals, and healthcare facilities across the nation, ensuring you can find care wherever you are.
The value of any health insurance plan depends largely on the providers available through its network. No matter how comprehensive your coverage, it's only useful if you can actually access quality doctors, hospitals, and specialists when you need them. Provider access determines whether you can keep seeing your current doctors, how far you'll need to travel for care, and whether you have options when choosing providers.
One of the most common complaints about health insurance is discovering that a preferred doctor or hospital isn't in-network, or that network options are limited in certain areas or specialties. Before choosing a plan, it's essential to understand the provider network and verify that the doctors you want to see are included.
Our health insurance plans feature expansive provider networks designed to give you real choices in your healthcare. With thousands of primary care physicians, specialists across every medical field, major hospital systems, urgent care centers, and ancillary providers, you'll find quality care close to home no matter where you live.
Thousands of family medicine physicians, internists, and general practitioners accepting new patients. Your PCP serves as your healthcare home, managing overall health, providing preventive care, and coordinating specialist referrals.
Comprehensive specialist network including cardiologists, orthopedists, dermatologists, neurologists, gastroenterologists, oncologists, endocrinologists, and dozens of other specialty physicians for expert care in specific conditions.
Major hospital systems, academic medical centers, community hospitals, and specialty hospitals nationwide. Access to emergency rooms, inpatient care, surgical services, and specialized units like cardiac care and oncology.
Walk-in clinics throughout the network for non-emergency care outside regular office hours. Evening, weekend, and holiday coverage means you can always access care when your primary doctor isn't available.
Over 60,000 in-network pharmacies including CVS, Walgreens, Walmart, Rite Aid, and thousands of independent pharmacies. Mail-order pharmacy options for maintenance medications with home delivery convenience.
Quest Diagnostics, LabCorp, and other diagnostic providers for blood work and lab tests. Imaging centers for X-rays, MRIs, CT scans, and ultrasounds at locations convenient to you.
Doctors, hospitals, and other healthcare providers who have contracted with your insurance company to provide services at negotiated rates. Using in-network providers gives you the lowest out-of-pocket costs and ensures your visits count toward your deductible and out-of-pocket maximum.
Providers without contracts with your insurance. PPO plans typically cover out-of-network care at higher cost-sharing, while HMO plans generally don't cover non-emergency out-of-network care. Understanding your plan's out-of-network benefits is important for flexibility.
Within the network, some plans designate certain providers as "preferred" with even lower cost-sharing. These are typically high-quality, cost-effective providers that the insurance company encourages members to use through financial incentives.
Hospitals and facilities recognized for exceptional quality in specific procedures like transplants, cardiac surgery, or cancer treatment. Some plans offer enhanced benefits or reduced cost-sharing when you choose these designated facilities for complex care.
Getting the most from your health insurance means understanding how to effectively use your provider network:
Before scheduling any appointment, verify that the provider is in your network. Network status can change, so check even with providers you've seen before. Use the online provider directory, call member services, or ask the provider's office to verify insurance participation.
Establishing a relationship with a primary care provider (PCP) gives you a medical home for preventive care, chronic disease management, and coordination of specialty care. Many plans require or encourage selecting a PCP, and some offer better benefits when care is coordinated through your PCP.
HMO plans typically require referrals from your PCP to see specialists. Even if your plan doesn't require referrals, getting one ensures the specialist has your medical records and context for the visit. Your PCP can also recommend specialists they trust.
For hospital procedures, verify that all providers involved are in-network: the hospital, surgeon, anesthesiologist, pathologist, and any other specialists. Ask specifically about potential out-of-network providers and request in-network alternatives when available.
Use our online provider directory to search by location, specialty, and provider name. You can also call member services for help finding providers. The directory shows which doctors are accepting new patients and provides contact information to schedule appointments.
Check our provider directory to see if your current doctor is in-network. If they're not, you can ask your doctor if they'd consider joining the network, or you may choose to see them as an out-of-network provider (if your plan covers out-of-network care) at higher cost.
Our network includes providers nationwide, so you can often find in-network care when traveling. For emergencies, go to the nearest emergency room regardless of network status; emergencies are covered at in-network rates. For non-emergencies, use our provider directory to find local in-network options.
If no in-network specialist of a certain type is available within a reasonable distance, you may be able to get an in-network exception for an out-of-network provider. Contact member services to request network adequacy review and potential authorization for out-of-network care at in-network rates.
Provider networks can change throughout the year as providers join or leave. Always verify network status before appointments. If your doctor leaves the network mid-year, you may be able to continue seeing them during a transition period or request a continuity of care exception for ongoing treatment.
Access to quality healthcare providers is the foundation of good health insurance. Our extensive network ensures you can find the right doctors, specialists, and hospitals near you. Speak with a licensed agent today to learn more about provider access in our plans.