Why stay in your plan's network
Your POS or PPO plan has a network of health care providers - doctors, hospitals, pharmacies, labs and more - and when you go to them to get services covered by your plan, two things happen.
You save money
Priority Health negotiates the fees in-network providers charge. So, even when you're paying "full price" before you meet your deductible, you're getting a discount.
You save paperwork
In-network providers bill Priority Health automatically for covered services. You'll have no claims to file.
What happens if you go out of network
Except for emergency care, and urgent care if you're outside the Priority Health service area, going to to out-of-network (also called "non-participating") providers for services covered by your POS or PPO plan will cost you more. You can see how much higher your out-of-network or "alternate benefit" copayments, coinsurance and/or deductible are when you log in to your MyHealth account.
If you are in a POS plan, you have a primary care doctor or other primary care provider, a "PCP." You don't need a referral from Priority Health to get care from an out-of-network provider, but some specialists will ask for a referral from your PCP.