When you use a doctor or hospital that participates in The First Health® Network, your benefit plan generally provides coverage at a higher level. The negotiated rate First Health makes available to your plan is usually less than full price for the covered service, which can translate into savings for you.*

The choice is always yours.

In the example below, you can see how your savings are achieved with a preferred provider organization (PPO). For this example, let's assume Maria is visiting her doctor because of flu symptoms. She has already met her deductible.

					In-network			Out-of-network
		Maria visits her doctor			Maria pays her $10 co-payment at the time of the visit. (The network's negotiated fee for her doctor's services is $45 rather than the normal fee of $60 for an office visit.)			Maria's out-of-network doctor requires payment up front. She must pay $60 at the time of the visit, file a claim form and wait for reimbursement. Because Maria has met her deductible, the plan pays 70% of usual and customary (U&C) fees. A charge of $50 is usual and customary, so Maria is responsible for the additional $10 above U&C.
		Claim forms are filed			Doctor files claims for Maria.			Maria must file her own claim forms
		Maria's cost			The $10 co-payment is all Maria pays.			The plan reimburses Maria $35 (70% of $50). Her total payment after reimbursement is $25.

Note: Plan provisions may differ. If you are already a member of a plan using First Health, please check your benefit documents for your specific coverage.