As a Bright Health member, you get access to an exclusive network of healthcare providers designed to offer a higher level of coordinated care and attention.
Together, with our network of primary care providers (PCPs) and specialists, we help ensure you get the care you need. Our robust network of doctors and Bright Medicare Advantage plan benefits help take the worry out of your healthcare, so you can focus on staying healthy.
When you chose a Bright Health Medicare Advantage plan, you were granted access to an extensive network of Baptist Memorial Health Care providers. When you see an in-network provider you keep your out-of-pocket costs down. In most cases, if you choose to see an out-of-network (OON) provider, services will not be covered by your plan and you will be responsible for the full cost of that service. Check your Summary of Benefits or Evidence of Coverage for details on services covered.
However, if you need OON emergency services, out-of-area urgently needed services, or out-of-area dialysis services, we’ve still got you covered.
Bright Health's coordinated network of providers also allows for your providers to get to know you and your health history, so you get the personalized care you deserve.
Do you know when to see your primary care provider instead of a specialist? Or when to go to the urgent care versus the emergency room (ER)? Your PCP is there for you to help navigate your care. If your PCP is not available or you need care more urgently, you have other options:
Using your PCP as your first line of support, helps ensure your care is relevant and on-target. Your PCP will work together with Bright Health and your healthcare team to coordinate your care for your best health outcome.
Last Updated: Tues Oct 1 2019
Bright Health plans are HMOs and PPOs with a Medicare contract. Bright Health’s New York D-SNP plan is an HMO with a Medicare contract and a Coordination of Benefits Agreement with New York State Department of Health. Our plans are issued through Bright Health Insurance Company or one of its affiliates. Bright Health Insurance Company is a Colorado Life and Health company that issues indemnity products, including EPOs offered through Medicare Advantage. An EPO is an exclusive provider organization plan that may be written on an HMO license in some states and on a Life and Health license in some states, including Colorado. Enrollment in our plans depends on contract renewal.
This information is not a complete description of benefits. Call 844-667-5502 | TTY:711 for more information.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
You must continue to pay your Medicare Part B premium.
Every year, Medicare evaluates plans based on a 5-star rating system.
Medicare beneficiaries may also enroll in Bright Health Medicare Advantage plans through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov
Bright Health Medicare Advantage plans are plans with a network of doctors, hospitals, pharmacies, and other providers. Out-of-network/noncontracted providers are under no obligation to treat Bright Health 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 must generally use network pharmacies to fill your prescriptions for covered Part D drugs.
Other providers are available in our network. Most network providers participate through our Care Partner.
Bright Advantage Special Care (HMO SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) through 2021 based on a review of Bright Advantage Special Care (HMO SNP) Model of Care.
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