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What you should know if you receive emergency services

As a reminder, if your health plan does not offer out-of-network benefits and you receive emergency care, or you are unable to obtain services from an in-network provider during an in-network facility stay or visit, you are not responsible to pay the difference between what your plan pays and what the health care professional charged.

Although we provide reasonable payment for emergency services, health care professionals who do not participate in our networks are not required to accept our payment as payment in full. If you receive a bill in connection with your recent health care visit, do not pay that bill.

If you receive services from an out-of-network health care professional for emergency care, or received services from an out-of-network provider while in an in-network facility, all eligible services will be processed at your in-network level of benefits. If you receive a bill from an out-of-network health care professional in connection with a recent emergency care visit, please call Member Services immediately at 1-800 355-BLUE (2583). State Health Benefits Program (SHBP) members should call 1-800-414-SHBP (4727).

Please know that non-emergency or elective services provided by health care professionals that do not participate with your plan may not be covered at the in-network level of benefits. These health care professionals may not accept our payment in full and may bill you additional amounts.

We encourage you to use in-network health care professionals and hospitals to get the most from your benefits and keep your out-of-pocket costs low. You can search for health care professionals and hospitals participating with your plan at HorizonBlue.com/doctorfinder.

Published on: November 1, 2017, 02:36 a.m. ET
Last updated on: November 1, 2017, 02:36 a.m. ET