If you are receiving care from a doctor who stops participating with us, please know we can help make sure you have access to the care you need, when you need it.
If our contract or agreement with an in-network doctor comes to an end, it means that the doctor is out-of-network.
We will make every attempt to work with your out-of-network doctor to develop an appropriate and safe plan to transition or move your care to an in-network doctor. When you see an in-network doctor, you are getting the best value—quality, affordable care with the lowest out-of-pockets costs.
Here’s some important information to help you make smart decisions and get the care you and your family needs.
Continuing Your Care With Your Current Out-of-Network Doctor…
In some cases, you may be able to continue care with your current out-of-network doctor for a period of time while you get ready to transition to an in-network doctor:
- If you are in the middle of a treatment plan—you may continue an ongoing course of treatment with an out-of network doctor for up to 90 days
- If you are pregnant, in the second or third trimester (3-month period)—you can continue care with an out-of-network doctor through delivery and for postpartum care after your delivery.
In addition, your doctor must agree to continue your care and to not bill you for charges above what we agree to pay.
If this applies to you, please call Customer Service at the number on the back of your ID card before you receive any more care to let us know that you’d like to continue care with an out-of-network doctor.
This period of time gives you and your doctor an opportunity to discuss a transition plan to an in-network doctor that fits your specific health needs. When the 90 days comes to an end, you will need to have care from an in-network doctor to pay the lowest out-of-pocket costs, and depending on your plan, to have your care covered.
We Can Help You Choose an In-Network Doctor…
If your doctor stops participating with us, it’s important to choose a new in-network doctor to provide care to you and your family. Your cost for care will always be the lowest when you use in-network doctors and hospitals. While we will make every attempt to work with your current doctor to develop a plan to help you seamlessly transition to a participating doctor, please talk to your current doctor to create a transition plan that’s right for you.
Need help choosing a new doctor?
- Use our online provider directory to help you find the best doctors for your specific needs
- Since quality and cost are important when choosing a doctor, sign up for Self-Service.so you can:
- Compare care and quality standards for our providers
- Read and write reviews about in-network doctors and hospitals
- See estimated costs for hospital procedures and detailed ratings including outcomes for specific procedures and quality of care
- If you need more information about in-network doctors or continuing your care, call Customer Service at the number on the back of your ID card weekdays, between 8 a.m. and 5 p.m.