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Doctor/Hospital Finder

Each Blue Cross of Northeastern Pennsylvania health insurance plan offers a different network of health care providers. Health care providers include doctors, hospitals, labs, radiology centers, radiologists, anesthesiologists and licensed therapists, to name just a few. Your costs for care will always be the lowest when you use doctors, hospitals and providers within your plan’s network.

Read below or click on the tabs to learn more about your plan’s network, get details on how to find an in-network doctor or hospital using our
doctor/hospital finder and learn more about where to go for care.

Understanding your network is important because your costs for care will always be the lowest when you use doctors, hospitals and providers within your plan’s network.

With some plans you may have coverage out of the network, but at a higher cost out of your own pocket, while other plans do not offer out-of-network coverage. This means it is important to understand your network, so that you can get the best value—top quality care at the lowest cost.

Below are links to resources to learn more about your network. Click on your plan’s name then take a look. You can also download or print the information. If you have questions, call Customer Service at the number on the back of your ID card, weekdays, between 8 a.m. and 5 p.m.

Remember, if you have health insurance through your employer, be sure to select “Group Insurance Plans” from the list below. Or select “Individual & Family Insurance Plans” if you are enrolled in one of our direct-pay individual health insurance plans.


Group Insurance Plans

BlueCare® PPO

BlueCare PPO uses the PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network. You also have coverage for care from national and worldwide BlueCard PPO providers—at the same low in-network cost for care, because BlueCard PPO providers are in-network. You have coverage for care out of the PPO and BlueCard PPO networks, but at a higher out-of-pocket cost. Doctors and hospitals out of the PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

BlueCare QHD PPO

BlueCare QHD PPO uses the PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from national and worldwide BlueCard PPO providers—at the same low in-network cost for care, because BlueCard PPO providers are in-network. You have coverage for care out of the PPO and BlueCard PPO networks, but at a higher out-of-pocket cost. Doctors and hospitals out of the PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

BlueCare Custom PPO

BlueCare Custom PPO uses the Custom PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You have coverage for care from Blue Distinction Centers for Transplants® and several hospitals and their participating doctors, located just outside our 13-county service area—at the same low in-network cost for care. National and worldwide BlueCard PPO doctors and hospitals are out of the network with your Custom PPO plan. You can use Blue Card PPO providers, and other providers outside of the Custom PPO network, but at a higher out-of-pocket cost. Doctors and hospitals out of the Custom PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

BlueCare QHD Custom PPO

BlueCare Custom QHD PPO uses the Custom PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from Blue Distinction Centers for Transplants® and several hospitals and their participating doctors, located just outside our 13-county service area—at the same low in-network cost for care. National and worldwide BlueCard PPO doctors and hospitals are out of the network with your Custom PPO plan. You can use BlueCard PPO providers and other providers outside of the Custom PPO network, but at a higher out-of-pocket cost. Doctors and hospitals out of the Custom PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

AffordaBlueSM

AffordaBlue uses the Tiered Custom PPO network. The Tiered Custom PPO network divides in-network providers into 2 tiers. Your cost for care is the lowest when you use in-network/tier 1 doctors and hospitals. Tier 1 includes the First Priority Life® (FPLIC) PPO network providers and care from Blue Distinction Centers for Transplants® and several hospitals and their participating doctors, located just beyond our 13-county service area. This network includes a 2nd tier to cover care from local doctors, hospitals and providers that charge a “facility fee.” You will pay more out of your pocket when you use in-network/tier 2 doctors and hospitals. National and worldwide BlueCard PPO doctors and hospitals are out of the network with your Tiered Custom PPO plan. You can use BlueCard PPO providers and other providers outside of the Tiered Custom PPO network, but at a higher out-of-pocket cost. Doctors and hospitals out of the Tiered Custom PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

BlueCare EPO

BlueCare EPO uses the EPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from national and worldwide BlueCard PPO providers—at the same cost for care as if you were home because BlueCard PPO providers are in-network. You do not have coverage for care outside of the EPO and BlueCard PPO networks, except in emergency situations. This means, unless it is an emergency, you must pay the full cost for care from doctors and hospitals out of the network. In emergency situations, you will be charged for your care as if you were in-network.

Get more information:

BlueCare Traditional

BlueCare Traditional uses the Traditional network. Using in-network providers for all covered medical care and services will always cost less, because your costs for care will always be the lowest in-network. Your health insurance plan offers the richest coverage with basically no deductibles, copays or coinsurance for care when you use in-network providers. You also have coverage for care from national and international BlueCard providers—at the same cost for care as if you were home. Coverage is provided for care out of the network, but at a higher cost out of your own pocket (deductibles, copays and coinsurance may apply). Doctors and hospitals out of the Traditional and BlueCard networks do not agree to accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

BlueCare HMO

BlueCare HMO uses the HMO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  National and worldwide BlueCard network doctors and hospitals are out of your HMO plan’s network. BlueCard providers can be used ONLY for urgent care and follow-up care. You will pay the low in-network cost for urgent and follow-up care ONLY with prior approval from Blue Cross of Northeastern Pennsylvania. You do not have coverage for care out of the HMO network, except in emergency situations. This means, unless it is an emergency, you must pay the full cost for care from doctors and hospitals out of the HMO network. In emergency situations, you will be charged for your care as if you were in network. If you use providers out of the HMO network, without prior approval from Blue Cross of Northeastern Pennsylvania, you will have to pay the full cost of your care.

Get more information:

BlueCare HMO Plus

BlueCare HMO Plus uses the HMO Plus network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care with national and international BlueCard doctors and hospitals—at a higher out-of-pocket cost for care. You do NOT have coverage for care outside of the HMO Plus and BlueCard networks—except in emergency situations or with prior approval from Blue Cross of Northeastern Pennsylvania. This means, unless it is an emergency, you must pay the full cost for care from doctors and hospitals out of the network. In emergency situations, you will be charged for your care as if you were in network. If you use providers out of the HMO network, without prior approval from Blue Cross of Northeastern Pennsylvania, you will have to pay the full cost of your care.

Get more information:


Individual & Family Insurance Plans

myBlue® Choice

myBlue Choice uses the PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from national and worldwide BlueCard PPO providers—at the same low in-network cost for care, because BlueCard PPO providers are in-network. You have coverage for care out of the PPO and BlueCard PPO networks, but at a higher out-of-pocket cost. Doctors and hospitals out of the PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

myBlue Choice LP

myBlue Choice LP uses the PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from national and worldwide BlueCard PPO providers—at the same low in-network cost for care, because BlueCard PPO providers are in-network. You have coverage for care out of the PPO and BlueCard PPO networks, but at a higher out-of-pocket cost. Doctors and hospitals out of the PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

myBlue Access

myBlue Access uses the Custom PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from Blue Distinction Centers for Transplants® and several hospitals and their participating doctors, located just outside our 13-county service area—at the same low in-network cost for care. National and worldwide BlueCard PPO doctors and hospitals are out of the network with your Custom PPO plan. You can use BlueCard PPO providers and other providers outside of the Custom PPO network, but at a higher out-of-pocket cost. Doctors and hospitals out of the Custom PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

myBlue Access LP

myBlue Access LP uses the Custom PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from Blue Distinction Centers for Transplants® and several hospitals and their participating doctors, located just outside our 13-county service area—at the same low in-network cost for care. BlueCard PPO doctors and hospitals are out of the network with your Custom PPO plan. You can use BlueCard PPO providers and other providers outside of the Custom PPO network, but at a higher out-of-pocket cost. Doctors and hospitals out of the Custom PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

myBlue Care

myBlue Care uses the Tiered Custom PPO network. The Tiered Custom PPO network divides in-network providers into 2 tiers. Your cost for care is the lowest when you use in-network/tier 1 doctors and hospitals. Tier 1 includes the First Priority Life® (FPLIC) PPO network providers and care from Blue Distinction Centers for Transplants® and several hospitals and their participating doctors, located just beyond our 13-county service area. This network includes a 2nd tier to cover care from local doctors, hospitals and providers that charge a “facility fee.” You will pay more out of your pocket when you use in-network/tier 2 doctors and hospitals. National and worldwide BlueCard PPO doctors and hospitals are out of the network with your Tiered Custom PPO plan. You can use BlueCard PPO providers and other providers outside of the Tiered Custom PPO network, but at a higher out-of-pocket cost. Doctors and hospitals out of the Tiered Custom PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

my Blue® Cross, a Multi-State Plan

my Blue Cross, a Multi-State Plan, uses the PPO network. Using in-network doctors and hospitals for all covered medical care and services will always save you money, because your costs for care are the lowest in-network.  You also have coverage for care from national and worldwide BlueCard PPO providers—at the same low in-network cost for care, because BlueCard PPO providers are in-network. You have coverage for care out of the PPO and BlueCard PPO networks, but at a higher out-of-pocket cost. Doctors and hospitals out of the PPO and BlueCard PPO networks do not accept our discounted “allowable charge” as payment in full. They may bill you for a bigger share of the cost for your care.

Get more information:

Use our Doctor/Hospital Finder to:
  • Find local in-network doctors, specialists, hospitals and other health care providers
  • Read reviews of doctors and hospitals and see office hours, phone numbers and addresses
  • Look for participating doctors and hospitals in our BlueCard® network for coverage almost anywhere with doctors and hospitals in every ZIP code across the U.S. and in more than 200 countries and territories worldwide
  • Find Blue Distinction Centers®, recognized for a proven history of quality care and fewer avoidable complications
  • Check to find in-network urgent care centers

When you logon or register for Self-Service you can do more than just search for in-network doctors and hospitals. You can also see what doctors and hospitals charge for certain procedures, read reviews to find out what other Blue members have to say about local doctors and share your own experience as a patient. This helps you find the highest quality of care at an affordable price. Learn more about how to compare cost and quality.

Make Sure All Your Providers Are In-Network

Keep in mind, even though a hospital may be in your plan’s network, not every doctor providing care in that hospital is in your plan’s network. This means it’s important to be sure all providers treating you are in your plan’s network before you make appointments to have care or check into a hospital. For example, if you are having surgery, check with your doctor or call Customer Service to make sure that all of your providers including surgeons, anesthesiologists and radiologists are in-network.

Where you go for medical care depends on how serious your illness or injury is. In most situations, when you are sick, you will save time and money by seeing your doctor. If it’s not an emergency, call your doctor first. Your doctor is best because he or she knows your medical history, medications and health issues. Many doctors offer same-day appointments, have a doctor on call for urgent care, or have options for reaching them or someone at their office during evening and weekend hours. Seeing your regular doctor will generally be quicker and cost you less than the ER. But in a true emergency, go to the ER.

If it’s not an emergency, your doctor isn’t available, and you can’t wait. You may consider an urgent care center. These are a convenient and low-cost option for care, when your doctor isn’t available. Urgent care centers have evening and weekend hours and give unscheduled, walk-in care for non-emergency illnesses and injuries. Urgent care centers are clinics staffed by doctors, nurses, physician assistants and other medical professionals.

Just Need To Ask a Question?

Blue Cross of Northeastern Pennsylvania members can reach a health professional 24/7 by phone to ask health questions, get advice on treating common health issues at home and find out if medical care is needed.

Find Out More About Your Blue Network

Learn about other ways Blue Cross of Northeastern Pennsylvania is providing you with top quality care from the most respected doctors and hospitals.

  • You can find information about your plan's network, select your health insurance plan on My Insurance Plan to get Your Network Book and Your Network Map.
  • Visit our Health Care Education Center to learn how to get the most out of your coverage, including tips for seeing your doctor and getting care when you’re sick
  • If you have a Blue ACA Metal plan, get ready for a visit to your doctor with our See Your Doctor brochure
  • Learn more about how we joined with Susquehanna Health to improve health care for patients in Clinton and Lycoming counties with the Patient Centered Medical Home Pilot Program
  • For more quality information on doctors, hospitals and pharmacies in our networks, see the Performance Report