Important Information About In-Network Providers

Our provider directory is subject to change without notice. Providers are periodically added or deleted. Prior to receiving services, ask your health care provider if she or he is in the network shown on your Blue Cross and Blue Shield of Nebraska member ID card, or you may call the Member Services number on the back of your ID card. View this flier to learn how to find your network name on your card.  

In addition, if your network doctor refers you to a specialist, ask the specialist if he or she is in the network shown on your ID card, or call the Member Services number on the back of your ID card.

It is always your choice when deciding which health care provider to use. But, if you use in-network providers, you are eligible to receive the highest benefit level possible under your plan for covered services. If you use out-of-network hospitals, doctors and other providers, you are still eligible, in most cases, to receive benefits for covered services, but the benefit level at which we pay for these services will be less than if you had gone to an in-network provider. In other words, if you use in-network providers, you will pay less out of pocket than if you use out-of-network providers.

Also, the selection of an in-network hospital does not guarantee that providers like anesthesiologists, radiologists, pathologists and emergency room personnel are in-network providers. If you receive care at an in-network hospital, be sure to ask about obtaining these services from in-network providers in order to receive the maximum possible benefits.

HEALTH INSURANCE TERMS


COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy


in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.