CLEAR OUTSTATE 2012.sv - Medica

Section 1 - Introduction
This directory provides a list of Medica Clear Solution℠’s network providers. To
get detailed information about your health care coverage, please see your
Evidence of Coverage.
As a health care consumer, you have choices to make. Medica offers the
Provider Directory as a tool to help you get the most from your plan. This
Provider Directory offers you a wide range of choices for participating providers
and hospitals available to members. In addition to participating with Medica,
these providers are approved by The Centers for Medicare and Medicaid
Services to treat those with Medicare coverage.
Providers You May See
As a member, you may choose to see any provider or specialist in the Medica
Clear Solution network without a referral. This includes care received from
primary care, specialty care or other providers. Our network serves 1.2 million
Medica members and includes 96 percent of area physicians, hospitals/clinics
and other health care providers.
• You will always receive the highest level of coverage by using Medica’s
contracted providers or network hospitals. Sometimes even network
hospital doctors are not aware that they need to send you to a network
hospital for inpatient care. If you need to go to a hospital, work closely
with your doctor to choose the most appropriate facility for your needs
from the many hospitals within the Medica Clear Solution network.
Otherwise, your costs will be much higher and you may be responsible for
paying the entire cost of the services you receive
• If you choose to see a provider who is not contracted with Medica for care
that isn’t emergency care or urgently needed care, you may pay higher
out-of-pocket costs or may be responsible for the entire cost of the service
provided to you.
Medica encourages you to establish a long term relationship with providers you
trust. A physician who knows your history and your needs is a valuable resource
in maintaining your ongoing health. You will find the providers in this directory
listed by general category, such as Primary Care, Specialty Care, Mental Health
and Substance Abuse, Eye Care, Rehabilitation, and Chiropractic.
Some of the things you should consider when choosing a physician are:
• Training and Experience. Find out whether the doctor is board-certified
and whether they have any special training. You can check a doctor’s
qualifications by using the resources on the next page.
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