Out of Town Access to Care

By David Donovan, Vice President of Sales, Independent Health

With the summertime months fast approaching and the kids off from school, many families use the time to take vacations across the country.   While people make their plans and pack their bags, the last thing on their minds is their health coverage.  But what if something happens while you are away?  Below is a brief overview of how Independent Health's out of area coverage works.

Emergency and urgent care

Independent Health offers members the security of knowing that if an emergency happens while they are out of town, they are covered.  Our commercial plans provide members worldwide coverage for emergency and urgent care visits. For emergencies, simply go to the nearest emergency room. You will be responsible for you emergency room copay, which is listed on your Independent Health card. 

Treatment at out-of-area urgent care centers is covered, too.  If you call Independent Health's 24-hour Medical Help Line before visiting the urgent care center, you will pay according to the in-network level of benefits (benefits and out-of-pocket costs vary by plan).

Prescription coverage while out of town

If you find yourself in need of a prescription or a refill on an existing prescription while you are away from home, Independent Health's National Pharmacy Network benefit can help you to obtain your medications.  There are more than 57,000 participating pharmacies nationwide.  To take advantage of this benefit, you need to have a prescription drug rider.  If you are unsure, you can call Independent Health's member services department at 1-800-501-3439 or (716) 631-8701 for more information.

Out-of-area flexibility

Most Independent Health plans provide coverage for members who choose to use an out-of-area doctor who does not participate with Independent Health.  Independent Health is partnering with First Health, one of the largest nationwide networks for health coverage.   The partnership now offers access to more than 4,700 hospitals and 500,000 doctors and health care professionals throughout the United States.   

First Health providers will accept Independent Health's payment in full and will not balance bill the member.  The member is still responsible for the plan deductible and coinsurance.  In addition, benefit limits and services that require pre-certification still apply.   To find out if you have this benefit, simply look at the back of your Independent Health ID card for the First Health logo. 

Independent Health is committed to providing quality care, whether our members are here in Western New York or out of town.  First Health and our National Pharmacy Network are two ways we can provide services for our members, where ever they may go.  As we work to implement real health reform, we will continue to collaborate with providers, physicians and hospitals to improve the access, quality and cost of care.