Understanding Your Health Insurance

Your insurance company partners with a number of healthcare providers. This group of providers is known as your insurance company’s network. When you select one of these providers, you are choosing someone who is in-network.

When a care provider, such as Benefis, is in-network, it means the provider works with the insurance company to negotiate mutually-acceptable rates of pay for medical services. When you receive care from a provider who is in-network with your insurance company, your insurance company typically charges you a lower fee, meaning you essentially receive a discount to get care at in-network facilities.

Only some healthcare providers have negotiated rates and are in-network with your insurance company. When you go to a provider who is out-of-network, your out-of-pocket cost is higher.

The actual amount you pay out-of-pocket depends on your insurance company and policy – it is not determined by your healthcare provider. Some insurance policies require you to pay a larger percentage of the total bill if you go out of-network, but others may not cover out-ofnetwork care at all. That can leave you, the patient, with the responsibility of paying a large medical bill yourself.

Consider whether a provider is considered in-network or out-of-network by your insurance company. Read your health insurance policy to see whether out-of-network care is covered at all. If it is, take note of what your financial responsibility would be compared to in-network care. You can also call your insurance company using the number on your insurance card to verify that you correctly understand your policy.

Medicare
Medicare Advantage
Medicaid
Tricare
TriWest
Indian Health Services
U.S. District Court
Veterans Administration

Allegiance Benefit Plan Management, Inc
Blue Cross/Blue Shield (Including: Blue Options, Heathy MT Kids, MCHA, HealthLink, Medicare Advantage, Federal Employee Plan)
CIGNA
Employee Benefit Management Services
Federal Bureau of Prisons
Humana
State of Montana Employee Plan
Logistics Health Incorporated
Malmstrom Air Force Base Active Duty
Montana Association of Counties (MACO) (Including Cascade County)
Montana Municipal Interlocal Authority (MMIA) (Including the City of Great Falls)
Montana COOP (Connect Care, Access Care, Engage)
Montana Air National Guard
Northwest Energy
Pacific Source
Pacific Steel and Recycling
United Healthcare

Aetna
Aetna Signature Administrators
AultCare
CoreSource
EBSO
First Choice Health Administrators
First Choice Health Network
HealthComp
MBA Benefit Administrators
Prodegi (formerly MBMC)
MultiPlan
National Foundation Life Insurance Co.
Regional Care, Inc.
Rocky Mountain Admin
WMI Mutual Insurance Co.
Zenith Administrators

Boulder Administration Services
City of Powell
Columbia Falls School District #5
CorVel
DAKOTACARE
EBSO
Equian
Fremont Motors
GlobalCare/Benefit Assistance Corporation
Group & Pension Administrators (GPA)
HealthEZ
IHC Health Solutions
Intermountain Wood Products
Meritain Health
Mid West National Life Insurance Company of TN
Montana Nonprofit Association (MNA)/CCS Inc.
NAHGA Claims Administrators
NovaNet
OutsourceOne Benefits
Patient Advocates LLC
PreferredOne Administrative Services
Premier Health Exchange (PHX)
Price Mine
Prime Health Services
Procura Management
Regional Care
Reynolds Market
Rockport Healthcare Group
Sheridan County of Montana
Starmark
Stratose
UMR
UT-ID Teamsters Security Fund
Van’s, Inc.