HMO Provider Important Information

HMO Provider Network Disclaimer

Your primary care provider (PCP) will coordinate all your health care. You can choose a pediatrician, internist, family or general practitioner listed in our on-line directory. You can choose a personal PCP for each member of your family, or you can doctor 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're also choosing a network. In most instances, you're not allowed to receive services from any doctor or health care professional who's not also part of your PCP's network unless services aren't available in the Limited Provider Network.

All your care will be provided by or arranged for within the network your PCP belongs to, so make sure your PCP's network includes the specialists and hospitals that you prefer. To find out 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 can visit a network OB/GYN without first obtaining a referral from the PCP. You aren't 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: Oct. 12, 2023