Back to Community

HealthCare Concierge Corner Pt.2

What Happens if Your Provider is Out-of-Network?

Having a reliable provider is beneficial to your healthcare. When you’ve found the provider who meets your needs, HealthTeam Advantage (HTA) values your choice, even if they’re out-of-network.

While we have an extensive provider network, we recognize you may be referred to a specialist, prefer an out-of-network doctor, or need medical attention when you’re out of town. Regardless of the reason, PPO members receive all plan benefits whether the provider is in- or out-of-network. The benefit to seeing in-network providers is lower out-of-pocket costs since in-network providers have negotiated rates with HTA.

If you see an out-of-network provider, they are not required to file your claims. If they don’t, you will likely be required to pay at the time of service and file a Direct Member Reimbursement with us.

You can find the Direct Member Reimbursement Requests online (medical, dental, vision) or you can contact your Healthcare Concierge by email or phone at 888-965-1965. They’ll be happy to help!


Happy senior couple spending leisure time in park.

How to Prevent Falls

While you probably didn’t consider falls a big deal when you were a kid, or even in your 20s and 30s, ...

Read More
Woman reading prescription bottle label.

How to Manage Your Medications

Taking daily medications can be challenging, especially if you take more than one. Here are some common ...

Read More

Subscribe to the Health Connection E-newsletter

Sign up for newsletter