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Find A Doctor Or Hospital In Your Network.
Before you go for care, make sure the provider is in your health plan network. Health professionals who have agreed to give care to you and other members in your health plan are called network providers. They may also be called in-network providers or participating providers.
Those without a contract to provide care are out-of-network providers.
It’s important to know the difference. By staying in the network, you can take advantage of lower rates and avoid surprise charges. In-network health providers and your Medicare plan have agreed to a set price for each treatment or procedure.
Someone who is not in the network can charge higher prices for the same care. You may also have to pay a higher copay or deductible for out-of-network care. Depending on your type of Medicare plan, out-of-network care may not be covered. Or it may only cover part, not all, of the full amount.
Out-of-network providers are under no obligation to treat Blue Cross Medicare Advantage members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Originally published 3/12/2019; Revised 2021, 2024