What are local health insurance networks and how do they work?
Who is this for?
This information will help you if you're shopping for health insurance and want to know more about the local HMO and EPO networks.
Local health insurance networks are just what they sound like. They're networks of doctors and hospitals focused in certain geographic areas.
We offer local HMO plans in Metro Detroit and Grand Rapids. And we offer a local EPO plan in Metro Detroit. With these plans, you'll need to get care from doctors and hospitals in your network. We'll only cover care out of your network if you have a medical emergency or accidental injury.
Because the networks are smaller, you'll save money on monthly premiums and out-of-pocket costs. These plans might be a good option for you if you don't travel away from home often.
If you have an HMO plan, you'll choose a primary care physician in your plan's network. They'll refer you to in-network specialists.
With an EPO plan, you have the flexibility to choose the doctors you see. But you also have the responsibility to make sure you're seeing in-network doctors.
With either type of plan, you'll want to make sure you know which doctors and hospitals are in the local network. You can start by looking at our individual and family plans.
But the best way to make sure a doctor is in a plan's network is to call and ask them. And don't just tell them it's Blue Cross. Make sure you give them the name of the specific plan and network.