Under this POS prefix, the member can access care both in-network and out-of-network, with cost-sharing that varies based on how the care is accessed. In-network care coordinated through the member's PCP has the lowest out-of-pocket cost. Include referral documentation when billing at the in-network benefit level.
Nonprofit health plan providing 6 million Californians with affordable healthcare coverage including HMO, PPO, dental, and vision plans for individuals, families, and employers.