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Find A Doctor Or Hospital In Your Network.
A network includes hospitals, clinics, doctors, pharmacies and others who take part in your health plan. All of these network providers agree to work with your health plan. That helps keep your costs down. If you visit a doctor outside your network, you may pay more for your care. Providers who do not have a contract in place with your health plan are out-of-network.
By staying in the network, you can take advantage of discounted rates and avoid surprise charges. That’s because in-network health providers and your health plan have agreed to a set price for each treatment or procedure in advance.
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. In some cases, you may even have to pay the full cost.
Before you go anywhere for care, make sure the provider or facility is in your health plan network. You’ll receive the same quality health care you should expect from any provider at the most affordable cost to you.
Try these tips:
To find providers in your health plan’s network, log in to your Blue Access for MembersSM (BAMSM) account and click Find Care in the top navigation menu. Then search using the Provider Finder® tool.
When you use a pharmacy that is in-network, you’ll save money. With some prescription drug plans, there can be another consideration. Along with in-network and out-of-network pharmacies, there may be a preferred pharmacy network in your plan benefits. If so, you’ll save the most money when you fill your prescriptions at preferred pharmacies.
To find an in-network pharmacy, log in to your BAM account and look under Find Care, then click Pharmacies.
If you’ve been using a pharmacy that isn’t in-network, it’s easy to switch. You can take your prescription bottle/bag to the new in-network pharmacy. Or you can call the new pharmacy and ask them to contact your current pharmacy. You can also ask your doctor to contact your new pharmacy.
Make sure to ask your doctor to send any new prescriptions to your network pharmacy. You may need to take your member ID card with you if it’s your first visit to the pharmacy or if you’ve changed health insurance plans.
Remember, whether it’s a doctor, clinic, hospital, therapist or other provider, you may pay less for care when you visit an in-network provider. That’s why it’s good to learn about your choices before you need care. It will help you be better prepared to take care of your health.
Originally published 10/1/2018; Revised 2022, 2023
Blue Cross and Blue Shield of New Mexico, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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