Care Coordination

Care Coordination access depends on the plan you have selected.

On ClearShare plans, you can use Care Coordination to find providers for labs, imaging tests, some surgeries, and other major procedures. In addition, Care Coordination can help you find local providers if the primary and secondary network doesn’t provide the coverage you need in your area .

On Major Medical Copay 3500, Copay 4500, and Copay 8000 plans, Care Coordination is embedded in the plan as a Tier 1 In-Network Preferred provider. Most services other than primary care and emergency services are eligible, but reference your plan documents for a complete list.

When Care Coordination is able to find a provider in your area that we recommend, your care is completely free. Our team will work diligently to find you a recommended provider, however there are instances where no provider is available. Care Coordination benefits are not guaranteed.

On Major Medical HSA 5000 and MVP plans, use of Care Coordination to access benefits or avoid penalty is required for most services. Reference your plan documents for a complete list.

When you need a service that is eligible for Care Coordination, we recommend contacting us at least 21 days before obtaining services. When you choose to see the provider we recommend, your care is completely free.

Our team will work diligently to find you a recommended provider, however there are instances where no provider is available. Care Coordination benefits are not guaranteed.

Care Coordination does not have a doctor lookup. The providers we recommend depend on a variety of factors. 

No, Care Coordination works to find and recommend you a fair-priced, high quality provider.

If you want to choose your own provider, you can use your plan’s applicable in-network or out-of-network services. 

Yes, we can recommend providers for a second opinion.

Yes, Care Coordination must be contacted and a provider must be recommended for each service in order to be eligible for waived out-of-pocket costs.