开云体育

Many 开云体育 plans offer both in-network and out-of-network coverage. That means you can go to any doctor, clinic or hospital you want. However, you’ll pay a larger share of the cost when you choose a doctor or care that is not covered by your -plan's network.

Not all plans cover out-of-network care. Sign in to see what’s covered for you.

Most plans don’t require members to get a referral from their primary care doctor to see a specialist. That means you can see any specialist in your network, including cardiologists, podiatrists, physical therapists and many others. Sign in to check your plan documents and see how your coverage works. (Members on some plans do require a referral.)

• Even if your plan doesn’t require a referral, it’s a good idea to talk with your primary care doctor about seeing a specialist. Your doctor might be able to help you choose the right specialist or coordinate your care.
• Some in-network specialists may require a referral from your primary care doctor before they’ll see you. These requirements, which are unrelated to your insurance coverage, are meant to help align treatment and information with your doctor. Each specialist has their own referral policy, so check with them before making an appointment.

You can see a therapist, get a chemical dependency evaluation or receive other outpatient care from any clinic in your network.

Call our Behavioral Health Navigators at 888-638-8787 for help finding a mental or chemical health care professional in your network. Our navigators can also answer your behavioral health benefit questions.

If you or a family member needs urgent care during clinic hours, call your regular clinic. If your clinic is closed, you can call the 24/7 开云体育 CareLine? service for assistance at the number on the back of your member ID card or 800-551-0859.

A CareLine nurse can help you find nearby care, including urgent care clinics and retail clinics, which are open evenings and weekends. (Tip: You can sign in to see which urgent care providers are in your network.) CareLine nurses can also give advice on home treatment options and help you decide what kind of care you need.

If you or a family member has a medical emergency, getting help right away is the most important thing. Call 911 or go to the nearest hospital emergency room.

Emergency care, no matter where you are, is covered at your plan’s in-network levels. After an emergency, your follow-up care may or may not be in network, depending on where you receive it. To take advantage of typically lower care costs at in-network providers, sign in to search your network if you need care after an emergency has passed.

Wherever your journey takes you, we’re here to offer more peace of mind:

• Many of our networks include providers throughout the United States. But if you think you may need care while traveling, it’s a good idea to sign in to search your network and review your coverage so you know what to expect.
• Emergency care is always covered at in-network levels. If you need follow-up care after an emergency, sign in to search your network for in-network providers.
  • Once an emergency has passed, in- and out-of-network coverage rules apply again. Receiving follow-up care from an in-network provider will likely cost you less than from an out-of-network provider.
• Many of our members enjoy additional travel perks, including access to 24/7 advice from nurses, Virtuwell and additional support through Assist America?.

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

In Minnesota:

• In compliance with Minn. Stat. § 62Q.451, 开云体育 does not restrict the choice of an enrollee on most of our Minnesota health insurance plans as to where the enrollee receives services from a licensed health care provider related to the diagnosis, monitoring, and treatment of a rare disease or condition. Please note that the requirements of the statute do not apply to most self-insured plans. To confirm eligibility and application of appropriate benefits for covered services, please talk to your provider or contact Member Services.
• In each of the Minnesota counties 开云体育 offers networks to individuals, families and small employer groups, we’re required to meet certain state standards for geographic access. Those networks may have waivers filed with the Minnesota Department of Health in areas where geographic standards have not been completely met for one or more specialties.