Provider Contract Updates

If a provider leaves our network, they will become an out-of-network provider. This means that you will pay more for out-of-network care. You may have benefits that cover some of the costs. Coverage varies based on benefits. You can log in to your online account or Excellus BCBS mobile app to view your plan coverage or call Customer Care, using the phone number on the back of your member card.

You should always seek emergency care if you believe you are experiencing a medical emergency at the closest location to you. If you go to an out-of-network hospital to receive emergency medical care, this will be considered in-network.

Some patients, including those who are pregnant or undergoing active treatment for cancer or a chronic condition, may qualify for extended in-network access through Excellus BCBS's Continuity of Care program. That means you can continue to receive care from the out-of-network provider at the in-network rate for a certain period of time.

• Please call Customer Care, using the phone number on the back of your member card, to see if you qualify, and to get instructions on how to continue to receive care based on your health plan.
• If you have insurance through your employer, contact your HR or benefits manager on coverage details.
• If your Continuity of Care request is approved, you will have in-network access to your current health care provider for a certain period of time.

If an agreement with the hospital isn't reached and the contract terminates (for example, on December 31, 2024), your in-network benefits would remain in effect for an additional 60 days. This additional 60-day period is called the "cooling off period." You would pay the in-network rate for hospital services during this period.

Under New York state law, this "cooling off period" does not apply to physician practices, which includes those practices that are affiliated with hospitals. Once the hospital contract ends, you would pay the out-of-network rate for care at the affiliated physician practices.

We understand some patients may have appointments scheduled on or after a termination date. If this is the case, you should call Customer Care, using the phone number on the back of your member card, to determine whether your procedure will be covered through Continuity of Care provisions.

You can find a list of providers who participate with your coverage using our Find a Doctor tool.

When you go to a healthcare provider that is "out-of-network," it means they don't accept your insurance. This usually means you'll have to pay more for the same services compared to using an "in-network" provider, who does accept your insurance.

Different insurance plans have different rules. Some cover out-of-network care, while others only cover it in emergencies, like if you have to go to the emergency room while traveling.

Learn how the difference between in-network and out-of-network care may impact your health costs.

Log in to your online account or Excellus BCBS mobile app to view your benefits and coverage.

If you need urgent or emergency care, learn more on our Care Options page.

For all other questions or help finding an in-network doctor or hospital, please call Customer Care at 1-877-883-9577 (TTY 711), Monday through Friday from 8 a.m. to 8 p.m.