HMO Provider Important Information

HMO Provider Network Disclaimer

Your primary care physician (PCP) will coordinate all your health care. You may select a pediatrician, internist, family or general practitioner listed in this on-line directory. You may choose a personal PCP for each member of your family, or you may select the same one for the entire family.

Limited Provider Networks

Your PCP may belong to a Limited Provider Network, an association of health professionals who work together to provide a full range of health care services.

That means, when you choose your PCP, you are also choosing a network and, in most instances, you are not allowed to receive services from any doctor or health care professional who is not also part of your PCP's network, unless services are not available in the Limited Provider Network.

All your care will be provided by or arranged for within the network to which your PCP belongs, so make sure that your PCP's network includes the specialists and hospitals that you prefer. To see if a PCP is in a Limited Provider Network, click on the provider's name in the search results.

The providers listed in the Limited Provider Network "Renaissance Physician Organization Network" is organized into multiple "PODS" (Provider Organization Delivery System). If you select a PCP with a Limited Provider Network of Renaissance Physician Organization Network, all your medical care must come from the providers who are in the Renaissance Physician Organization Network and generally, from within your selected PCP's POD(s).

Attention Female Enrollees: For preventive care (well-woman exams), gynecological conditions, or maternity care, female members may see a network OB/GYN without first obtaining a referral from the PCP. You are not required to select an OB/GYN; you may elect to receive your OB/GYN services from your PCP. If your PCP belongs to a Limited Provider Network, you must see a network OB/GYN participating in the same Limited Provider Network.

 

Last Updated: June 17, 2021