A preferred provider is a health care provider
(doctor/clinic/hospital) with whom the Plan has negotiated reduced
rates. Using preferred providers
saves you money with lower out-of-pocket expenses and
ultimately, lower employee contributions. Using
preferred providers saves the Plan money with lower medical
expenses. The Plan has different preferred provider
arrangements based on location. An out-of-network
penalty is applied when a preferred provider is available and
you choose to use a non-preferred provider.
You may use
any physician without penalty. Out-of-network
penalties do not apply to individual physicians; however,
using a preferred provider physician outside the State of
Alaska will save money.
You are free to use any
facility you choose; however, an out-of-network penalty
will be applied if you do not use a preferred provider
facility. In all locations, your reimbursement rate
will be reduced by 20% of the first $50,000 in covered charges. In addition, within the
Municipality of Anchorage, the allowable
amount cannot exceed the amount the preferred provider charges
the Plan. See the
individual preferred provider pages for examples.
Please review the preferred providers
appropriate for your location.