Knowing your health plan’s network

It's good to know what providers your Wellpoint health plan will help pay for. Using these in-network doctors and health centers can help you save money. Doctors in your network agree to charge less for Wellpoint members. You can easily look for doctors in your Wellpoint network. It's important to know the difference between doctors who are in your network and those who aren't.

How to find in-network doctors with Wellpoint

 

Wellpoint has many doctors and health centers for you to choose from. Here is how you can find the right one.

 

Personalized search for Wellpoint in-network doctors

 

Log into your member portal or the Sydney℠ Health mobile app for a personalized search experience. This can help you look for doctors and show you how much different health services might cost. However, not all plans have this option.

 

To access the member portal on a computer, tablet, or smartphone:

  • Visit https://www.wellpoint.com/login/
  • Select Care in the bottom navigation and choose Find Care
  • You can also select the menu in the bottom right corner, then click Access Care and choose Find Care.

 

To use the Sydney Health app, download the app from your mobile device’s app store:

 

Once you create an account and log in, select Care, then Find Care and Cost, and choose a provider to see if they’re in your network.

 

Basic search for Wellpoint in-network doctors

 

If you can’t use your member portal or the Sydney Health mobile app, don’t worry. You can still use the find care tool on the Wellpoint site to do a basic search. You will enter the type of network, the state for your plan, how you get your health coverage, and the name of your Wellpoint plan.

Find more about what your Wellpoint plan covers

 

To find doctors who accept your Wellpoint plan, look at your plan details. You can find this information in your member handbook or by logging into your member portal. You can also use the Sydney Health mobile app. Here’s how you can look up what your plan covers for different doctor visits:

Wellpoint in-network providers

 

In-network providers or preferred providers are doctors and places that work with Wellpoint. They give care to members at a lower cost. Using doctors in your network helps make healthcare cost less.

 

In-network doctors do tasks like filling out forms for filing claims and requesting preapprovals. This saves you time and is less paperwork for you. Wellpoint makes sure that the doctors and places for treatment in network are great. When you pick an in-network doctor, you know you’re getting good care.

Wellpoint out-of-network providers

 

Out-of-network providers are doctors and places for treatment that don't work with Wellpoint. Seeing them usually costs more. If a doctor charges more than what your insurance pays, you might have to pay the rest. This is called balance billing. You might also need to fill out your own forms for claims and request preapprovals. This can take a lot of time and be confusing.

 

You might still pick a doctor or a health care location that doesn't work with Wellpoint. This might happen if there aren’t any doctors who work with Wellpoint near you. Or, you might want to keep seeing a doctor you already like, even if they're not in your plan's network. Seeing doctors in your plan's network is usually easier and costs less. Wellpoint suggests you see these doctors whenever you can. If you choose to see an out-of-network provider, please note that you may need a referral or preauthorization for coverage with your plan.

Live chat with Member Services

 

Wellpoint wants to help you understand your health plan and find the right doctors. If you have questions or need help, you can chat live with Member Services. Log into your member portal or the Sydney Health mobile app and use the live chat feature for quick and personalized help. To use Sydney Health, download from the App Store or download from Google Play.

 

Wellpoint’s large network of doctors gives you many choices for finding great care that is not too expensive. Knowing about your network helps you make smart choices and get the most from your Wellpoint plan.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. You can find the phone number for member services on the back of your ID card.

 

For Individual and Family plan member support, hours are 8 a.m. to 8 p.m. local time daily October 1 through March 31 and Monday to Friday from April 1 through September 30. For Medicare and Medicaid, hours vary by state. Check your member handbook or Sydney Health app for current hours. TTY users should call 711.