Out-of-Network Medical Coverage

With limited exceptions, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, when you are out of the area), out-of-area dialysis services, when accessing additional benefits and services covered exclusively by Medicaid using your New York State issued Medicaid identification card (for our SNP members), and cases in which Healthfirst Medicare Plan authorizes use of out-of-network providers.
For further information, please refer to Chapter 3 of your Evidence of Coverage with links provided at the bottom of this page.