Make sure you show your member ID card whenever you see a provider or fill a prescription. Pharmacies and providers need this information to charge you the right amount and bill your plan correctly.
Here are some of the many advantages to using network providers:
To find a network provider, use the Provider Search tool, or call Customer Service at 1-888-849-3681.
Using non-network providers will cost you more, often much more (see table below). Even if you are referred to a non-network provider by a network provider, claims will be paid at the non-network rate.
This example assumes you've met your medical deductible.
| Network Provider | Non-network Provider | |
|---|---|---|
| Provider's Billed Charge | $150 | $150 |
| Allowed Amount | $100 | $100 |
| Provider Discount | -$50 | 0 |
| Total Charge That Must Be Paid | $100 | $150 |
| What Your Plan Pays (% of Allowed Amount) |
$85 (85% of $100) | $60 (60% of $100) |
| What You Pay (Balance) |
$15 | Member coinsurance (40% of plan allowed): $40 Difference between allowed and provider's billed charge: $501 Total you pay: $902 |
1 This amount does not apply to your medical deductible. |
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If you are enrolled in Medicare and receive services from a provider who accepts Medicare, the services will be paid at the network level. For more information on how UMP and Medicare work together, see our Frequently Asked Questions about Medicare.
Physicians such as anesthesiologists and emergency room doctors may not be network providers, even if they work at a network hospital. Check our Provider Search tool or call Customer Service at 1-888-849-3681 before scheduling surgery to make sure your providers are in-network.