As an 1199SEIU member, you have access to thousands of healthcare providers within our Beneﬁt Fund’s network. That means you can avoid paying unnecessary out-of-pocket costs when you use participating providers. Doctors who are not in the network can charge anything they want, which can be a lot more than the Fund’s reimbursement rate, and you have to pay the full balance. So going outside of our network to a non-participating provider could result in an expensive – and avoidable – medical bill, so make sure that your doctor, and any provider he or she may refer you to, is part of our network.
- To find a participating provider, visit our Find an 1199SEIU Provider page, and search by specialty, location or hospital network. If you need help choosing an in-network provider, just call our Member Services Department at (646) 473-9200 and one of our representatives will assist you.
- When you make an appointment with any healthcare provider, you should confirm that the provider still participates in the Fund’s network. That includes your primary care doctor; your pharmacy; surgeons and anesthesiologists if you need an operation; imaging centers or labs if you have X-rays or tests done; and any other referrals or specialists. And if your doctor writes you a prescription, remember to check the Preferred Drug List (PDL) to make sure your medication is fully covered.
Sometimes, where you get healthcare, or who provides it, is out of your control—such as when you need emergency care or when a non-participating provider is involved in your care without your knowledge or choice. This can result in your receiving a surprise bill, also known as balance billing. Starting January 1, 2022, the No Surprises Act provides protections against non-participating providers balance billing you in certain situations. To learn more about how the No Surprises Act protects you from surprise medical bills, see the Federal Balance Billing Notice.