You can get care from any doctor in your plan. And you don't need a referral from your main doctor. Rarely, you may need care and there's no one in your plan who can give you the health care service you need. You or your doctor can then ask to be referred to someone not in your plan— for no more cost to you than if you had seen someone in your plan.
If your primary doctor can’t see you that day or the next, you should find an urgent care clinic nearby. Log in and click on Find Urgent Care for one in your network.
It can take up to 10 business days or two weeks.
Call them. They should always have someone available, or a recorded message to help you get the care you need.
Doctors, hospitals, facilities (such as labs) and other professionals who give health care services may have a contract with us. If they do, they're in our network - also called in-network providers. That means they've shown they provide quality care and they accept our payment rates when our members go to them for care. If they don't have a contract with us, they're outside of our network - or out of network providers.
Many of our networks are made up of providers who meet high quality standards. Network providers are responsible for getting any needed precertification (approval) for your care. They also file your claim for you and will seek payment from us for covered services.
When you see network providers, you only have to pay the copays, deductibles and coinsurance required by your health plan. If you get treatment from a provider outside the network, you could have to pay more. Check your plan document (your contract, Evidence of Coverage, Summary of Benefits, Certificate of Coverage, or Member Handbook, etc.) for details.
Yes, although it does not make the most of your benefits and may end up costing you more. Check your plan document (your contract, Evidence of Coverage, Summary of Benefits, Certificate of Coverage, or Member Handbook, etc.) to learn more.
NOTICE: There are hospitals, health care facilities, physicians or other health care providers who are not included in every plan network. Your financial responsibilities for payment of covered services may differ if you use a network provider or a non-network provider. Please refer to the online Find a Doctor tool to determine if a particular provider is in the network, or contact customer service for assistance.
You could ask your doctor to call us and apply to join the network. Until your doctor becomes a provider in the network, changing to a network doctor will help you pay less and make the most of your benefits.
A primary care physician (PCP) is your main doctor. Always try to go to your PCP first for health concerns or questions.
Your PCP coordinates any other care you need, such as a visit to a specialist or a hospital stay. You may need to contact your PCP to get an OK (prior authorization) before you get certain services.
Most PCPs are family or general practitioners, internists or pediatricians. These types of doctors have gone to school to learn about all areas of health. That way, they can get a strong, overall picture of your health.
Not all health plans require you to have a PCP. Check your plan document (your contract, Evidence of Coverage, Summary of Benefits, Certificate of Coverage, or Member Handbook, etc.) for details.
In emergencies, call 9-1-1 or go to the nearest hospital - you don’t need an OK from us or your PCP. But be careful not to use the emergency room unless it really is an emergency.
If it’s not an emergency, you can see a doctor right away online, using your phone or computer at livehealthonline.com. Depending on your plan, it’s likely about the same cost as your doctor.
You can also use our Find a Doctor tool to look for an urgent care center - or a clinic in a retail shopping store. You can usually walk in without an appointment needed. And they can handle lots of urgent health issues like a flu or cold, allergies, prescribing medication, even small fractures and X-rays.
If it’s not an emergency, you can see a doctor right away online, using your phone or computer at livehealthonline.com. Depending on your plan, it’s likely about the same cost as your doctor.
You can also use our Find a Doctor tool to look for an urgent care center - or a clinic in a retail shopping store. You can usually walk in without an appointment needed. And they can handle lots of urgent health issues like a flu or cold, allergies, prescribing medication, even small fractures and X-rays.
You may need to contact your Primary Care Physician (PCP) to get an OK (preapproval) before you get certain services, including behavioral health services. Your PCP will work with you to decide if you need to see a specialist. If so, your PCP will refer you to a specialist in your plan. If you have to refer yourself to a specialist, you can search for a specialist in your plan using our online directory. Check your plan document (your contract, Evidence of Coverage, Summary of Benefits, Certificate of Coverage, or Member Handbook, etc.) for details.
Get a full list of the types of doctors, hospitals and other health care providers. Log in to and choose Find a Doctor.
Do I need to make sure pharmacies, labs or other places my doctor refers me are also in the network?
It's a good idea to always go to your own network to find doctors and other health care providers.
If you change your PCP on the 1st day of the month, the change will apply on the same day. Any changes made on the 2nd day of the month through the end of the month will apply on the first day of the following month.
First log into your secure site. Once logged in, click Find a Doctor and answer the required questions to complete your search.
Log into your secure account and go to Find a Doctor If you are doing a search when you are not logged into your secure account, please be sure that you are double checking to make sure that the doctor or facility is in network before scheduling an appointment. If you need further help, please read on
The following definitions are for the Behavior Health Types:
Applied Behavior Analyst - specializes in analyzing overt (publicly observable) behavior, use procedures based on operant procedures.
Behavior/Substance Abuse - Facilities specializing in mental health and substance abuse.
Board Cert Assistant Behavior Analyst - Board Cert Assistant Behavior Analyst.
Hospital Psychiatry - A specialized behavioral health services unit within as General Hospital that provides 24-hour acute inpatient care for the evaluation and treatment of mental health or chemical dependency disorders under the supervision of physicians and nurses.
Marriage and Family Therapists - A practice specialty that uses counseling and other psychotherapeutic techniques with individuals, couples, families, and groups to treat a variety of life problems. These may include mental and emotional disorders and/or alcohol and other drug problems.
Nurse Practitioners, Nurses - Nurse practitioners and nurses with special training and experience in the prevention, diagnosis, and management of problematic behaviors.
Other - Other service providers not listed, such as state agencies.
Pediatrics (Children) - Specialists in the diagnosis and treatment of the diseases of infants, children and adolescents.
Professional Counselors - Specialists who provide professional counseling services involving psychotherapy, human development, learning theory,and group dynamics to individuals, couples, and families.
Psychiatry - Physicians who have medical training which enables them to understand the complex relationship between emotional illness and other medical illnesses.
Psychiatrists specialize in the diagnosis and treatment of mental and emotional illness and alcohol and other drug problems, including detoxification and rehabilitation by using a combination of counseling, psychotherapy, and medications.
Psychologists - A practice specialty that uses psychotherapeutic techniques with individuals, couples, families and groups to diagnose and treat mental and emotional disorders and/or alcohol and other drug problems. Develops, administers and interprets tests of mental abilities, aptitudes, interest, personality characteristics and motivations to aid in the assessment and diagnostic process.
Social Workers - Specialists trained
The following definitions are for the Dental Provider Types:
Dental Group Practice - A group of dental service providers, who are practicing in one location to study, manage and treat of diseases and conditions affecting the mouth, jaws, teeth and supporting tissues.
Behavior/Substance Abuse - Facilities specializing in mental health and substance abuse.
Endodontics - The branch of dentistry dealing with the cause, diagnosis, prevention, and treatment of diseases of the dental pulp, usually by removal of the nerve and other tissue of the pulp cavity and its replacement with suitable filling material, such as a root canal.
General Practice Dentistry - Nonspecialized dental practice which is concerned with providing primary and continuing dental care.
Oral Surgery - Diagnosis and treatment requiring an extraction or other form of oral surgery.
Orthodontics - the branch of dentistry concerned with preventing or correcting irregularities of the teeth.
Pediatric Dentistry - the goal of pediatric dentistry is to teach children the importance of oral hygiene, how to take care of their teeth and to help children feel comfortable about visiting the dentist.
Periodontics - the branch of dentistry dealing with the study and treatment of diseases of the periodontium (the bone, connective tissue, and gum surrounding and supporting a tooth).
Prosthodontics - the branch of dentistry that deals with the restoration and maintenance of oral function by the replacement of missing teeth and other oral structures by artificial devices.
The following definitions are for the Doctor & Other Health Professional Types:
Acupuncture - Acupuncture is a Chinese medical practice or procedure that treats illness or provides local anesthesia by the insertion of needles at specified sites of the body.
Allergy/Immunology - Specialists in the diagnosis and treatment of hypersensitive states resulting from exposure to a particular allergen and diseases of the immune system. Sub-Specialties include: "Allergy", "Allergy/Immunology", "Immunology", "Pediatric Allergy", "Pediatric Immunology".
Anesthesiology - Specialists in the relief of pain during surgery and childbirth, and control of pain due to various causes. Sub-Specialties include: "Anesthesiology", "Anesthesiology Critical Care Medicine", "Anesthesiology Pain Center", "Hospital Based Physician-Anesthesiology", "Nurse Anesthetist", "Pediatric Anesthesiology".
Audiologists - Studies hearing disorders, including evaluation of hearing function and rehabilitation of patients with hearing impairments.
Cardiology - Specialists in the study of the structure, function and diseases of the heart.
Sub-Specialties include: "Cardiac Electrophysiology", "Cardiology", "Cardiothoracic Surgery", "Cardiovascular Disease", "Echocardiography", "Hospital Based Physician-Cardiology", "Interventional Cardiology", "Licensed Perfusionist", "Nuclear Cardiology", "Pediatric Cardiology".
Sub-Specialties include: "Cardiac Electrophysiology", "Cardiology", "Cardiothoracic Surgery", "Cardiovascular Disease", "Echocardiography", "Hospital Based Physician-Cardiology", "Interventional Cardiology", "Licensed Perfusionist", "Nuclear Cardiology", "Pediatric Cardiology".
Chiropractic - Specialists in the non-drug treatment of musculoskeletal problems, including joint sprains and disk injuries. Sub-Specialties include: "Chiropractor", "Chiropractor - Neurology", "Chiropractor - Occupational Medicine", "Chiropractor - Radiology", "Chiropractor - Sports Physician".
Colon/Rectal Specialists - Specialists in the treatment of disorders of the large intestine and rectum. Sub-Specialties include: "Anorectal Surgery", "Colon/Rectal Surgery", "Proctology".
Critical Care Medicine - Specialists in the care for critically ill patient in intensive care unit. Sub-Specialties include: "Internal Medicine Critical Care Medicine", "Neurological Surgery Critical Care Medicine", "Surgical Critical Care".
Dental - The study, management and treatment of diseases and conditions affecting the mouth, jaws, teeth and supporting tissues. Sub-Specialties include: Prosthodontics.
Dermatology - Specialists in the diagnosis and treatment of diseases of the skin. Sub-Specialties include: "Dermatology - Dermatological Surgery", "Dermatology Immunology/Diagnostic Laboratory Immunology", "Pediatric Dermatology".
Dieticians/Nutritionists - Special
The following definitions are for the Hospitals And Facilities Types:
Extended Care, Hospice, Skilled Nursing - Facilities designed for those who need assistance with day-to-day activities or medical needs (extended care facility), those who require a higher level of medical care monitored by nurses and other medical personnel (skilled nursing facility) or those who are facing life-limiting illnesses and no longer respond to cure-oriented treatments (hospice). Sub-Specialties include: "Agency - Nursing Care", "Chronic Care Facility", "Extended Care Facility", "Family Medicine Hospice and Palliative", "Hospice", "Hospice and Palliative Medicine", "Hospice Care, Community Based", "Hospice, Inpatient", "Internal Medicine-Hospice & Palliative Medicine", "Limited Care Facility", "Long Term Acute Care Hospital", "Long Term Care Hospital", "Nursing Home", "Skilled Nursing Facility".
Alternate Care Facility - Facility for the diagnosis and treatment of illnesses and injuries with the use of electromagnetic radiation, ultrasonics, and other forms of radiant energy. Sub-Specialties include: "Radiology Center".
Behavioral/Substance Abuse - Facilities specializing in mental health and substance abuse. Sub-Specialties include: "Behavioral Health Center", "Behavioral Health/Substance Abuse Facility", "Behavioral Health Facility", "Eating Disorder Facility", "Partial Day Intensive Outpatient", "Partial Day Outpatient", "Partial Day Psychiatric & Substance Abuse", "Psychiatric-General Hospital", "Rehabilitation, Comprehensive Outpatient Facility", "Residential Treatment", "Substance Abuse Disorder Rehabilitation Facility - Substance Abuse Treatment, Children", "Substance Abuse Facility",
Clinics - Facilities that provide management and treatment of patients with minor complaints or illnesses. Services may include primary care, dental, family planning and/or well child services. Sub-Specialties include: "Cardiology Center", "Clinic/Center - Federally Qualified Health Center (FQHC)", "Clinic/Center - Infusion Therapy", "Clinic/Center - Methadone", "Clinic/Center - Occupational Medicine", "Clinic/Center - Oncology, Radiation", "Clinic/Center - VA", "Community Mental Health", "Community Health Clinic", "Coronary Services Center", "Diabetic Education Center", "FED QUAL HLTH CLIN", "Kidney Disease Treatment", "Lithotripsy Provider", "Nursing School Clinic", "RES TRTMT CNTR".
General/Acute Care Hospital - Institutions offering residential, investigatory, and/or therapeutic care regarded as too complex or specialized for provision as home-care services. Services may be on an inpatient or out-patient basis. Sub-Specialties include: "Acute Care Hospital", "Children's Hospital", "Christian Science Sanitoria-Hospital", "General Acute Care Hospital - Critical Access", "General Acute Care Hospital - Rural", "General Acute Care Hospital - Women", "Indian Health Svcs/Public Health Svcs ( IHS/PHS ) Hosp", "Intensive Care Hospital", "Veterans Hospital".
Other - Other service providers not listed, such as state agencies. Sub-Specialties include: "Ambulatory Infusion Ctr", "Anesthesiology Pain Ctr", "Bariatrics", "Birthing Center", "Clinic/Center - Pain", "Clinic/Center - Radiology, Mobile", "Clinic/Center - Radiology, Mobile Mammography", "Clinic/Center - Student Health", "Freestanding ER", "Hematology Center", "Hemodialysis", "HOME INFUSION THERAPY", "Home IV (Facility)", "Hyperbaric Facility", "Military Hospital", "MRI Facility", "Naprapathy", "Native American Clinic", "OUTPAT C/D SVCS", "Pain Management Centers", "Sleep Disorders Center", "Special Hospital", "Specialized Facility", "Transitional
The following definitions are for the Vision Types:
Ophthalmology - Vision providers who specialize in the diagnosis and treatment of diseases and disorders of the eye. Sub-Specialties include: "Neuro-Opthalmology", "Ophthalmology", "Ophthalmology, Otology, Laryngology, Rhinology (Osteopaths only)", "Opthalmic Plastic".
Optician - Optician a person who makes or sells eyeglasses and, usually, contact lenses, for remedying defects of vision in accordance with the prescriptions of ophthalmologists and optometrists.
Optometrist - Vision Therapy - Vision therapy is a type of physical therapy for the eyes and brain, a highly effective non-surgical treatment for common problems.
Optometry - the practice or profession of examining the eyes, by means of suitable instruments or appliances, for defects in vision and eye disorders in order to prescribe corrective lenses or other appropriate treatment.
Vision Facility - Eyewear suppliers or optical stores, such as Pearle Vision® or Sears Optical. Sub-Specialties include: "Eyewear Supplier", "Optical Store".
