Network Providers

It is important for you to understand the difference between in-network providers and out-of-network providers when using your CoOportunity Health coverage. As a general rule, you should always use in-network providers when you seek care to save on your out-of-pocket costs. Here are five tips to make the most of your health insurance coverage by using in-network providers.

Use In-Network Providers

Your coinsurance, deductible and out-of-pocket maximum are less when using in-network providers. Plus, in-network providers agree to accept our payment for covered services and cannot balance bill you for the difference between their charge and the CoOportunity Health allowed amount.


Develop a Relationship with a Primary Care Provider

Most CoOportunity Health plans feature a lower copayment when you get care from a primary care provider.* Primary care providers include the following: Internal Medicine, Family Practice, General Practice, Pediatrics, Obstetrics/Gynecology, Adolescent Medicine, Adult Medicine and Geriatrics. In addition, outpatient behavioral health and chiropractors also have the same copayment as primary care providers.

Take Advantage of Three-for-Free

In many plans, your first three office visits are free. This includes in-network primary care, specialists and outpatient behavioral health. Every covered family member has three free office visits. If you need other services such as an X-ray or a lab test, you’ll be responsible for the costs based on the cost-sharing of your plan. Combine this with your free preventive care and you may not have to pay any copays for office visits if you don’t go to the doctor often.

Get the Preventive Care You Need

Most of us have heard the saying, “An ounce of prevention is worth a pound of cure.” That holds true to your health. It is better to find out about a health problem when it is in its early stages. Best of all, preventive care is free. That means you don’t have to pay anything out-of-pocket.

Find Providers When You Are Away From Home

Not only do you have access to local network providers, our national provider networks — the PHCS Network and the MultiPlan network — allow you to receive care from an in-network provider and receive network savings even when you’re not home.

Quick Tools: Provider Networks

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