Important Information About NEtwork BLUE

The 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 a NEtwork BLUE provider, or you may call the Member Services number on the back of your ID card.

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

With NEtwork BLUE, it is obviously to your advantage to use our network of preferred hospitals and doctors, but it still remains your choice.

If you use preferred hospitals and doctors, you are eligible to receive the highest benefit level possible under your NEtwork BLUE plan for covered services. If you use non-NEtwork BLUE 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 a preferred provider.

Selection of a NEtwork BLUE hospital does not guarantee that the anesthesiologists, radiologists, pathologists and emergency room personnel are preferred providers. Patients receiving care at a NEtwork BLUE hospital are advised to inquire about obtaining these services from NEtwork BLUE providers in order to receive maximum possible benefits.



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


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. 


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.


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.)


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


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.


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.


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).


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.