Getting Health Care Where You Are

 

On vacation? Student away at school? Wintering away from home?


You may need health care when you’re outside of your Provider Network. What do you do? Follow the steps for Emergency Care or Urgent Care.


If you are planning a long trip outside the Quartz service area, talk to your PCP. Make sure you know how to get medical care while you are away.


HMO members:  If you need follow-up visits after emergency or urgent care, you must go to a ​Quartz participating provider. In addition, routine or preventive visits must be from a Quartz participating provider.


POS, Choice, Choice Plus, My Choice and PPO members: You can visit non-participating providers. Please check your benefitsMyChart link to make sure you understand your plan. For My Choice members, services are covered up to the usual, customary and reasonable charge (UCR). You may be responsible for paying charges that are above the UCR and other out-of-pocket costs.


Note: You may have to pay some charges if you use an emergency room or go to urgent care. Check your Schedule of Benefits, Summary of Benefits and Coverage, or Certificate of Coverage in MyChartMyChart link for your plan benefits.


When traveling, you may need to get emergency or urgent care or fill a prescription. All Quartz plans cover out-of-area emergency and urgent care services. Depending on your plan, you may need to pay some costs for these services.


Sometimes you need to pay the full cost for these services when you receive them.  In this case, you can fill out a Member Claim Form and include an itemized receipt and proof of payment. For prescriptions, you can fill out a Direct Member Reimbursement Form and include proof of payment. In either case, ​Quartz will pay you back based on your plan coverage.

 

Questions?

Get in touch with Customer Service by sending a message.MyChart link