Pharmacy Directory for all plan options
|State, Education, and Local Government Employees Plan|
Click here for State, Education, and Local Government Employees prior to 2023
|Medicare Advantage and Generations State of Oklahoma Group Retirees (HMO)|
|Medicare Advantage D-SNP Plan|
Click here for Medicare Advantage Pharmacy information prior to 2023
This directory provides a list of GlobalHealth’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).
You will have to choose one of our network providers listed in this directory to be your Primary Care Provider (PCP). Your PCP will provide a wide array of basic and routine services. Each provider type subsection in this Provider Directory tells you if you need a referral or not. For more information on services you may obtain without a referral, please see Chapter 4 of your Evidence of Coverage.
The network providers listed in this directory have agreed to provide you with your healthcare vision, and dental services. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. Other physicians/providers are available in our network.
Generations Classic Choice (HMO-POS) members may receive care from an out-of-network provider for certain benefits. However, our Provider Directory only includes providers who are in network. If you use an out-of-network provider, your share of the costs for your covered services may be higher. See your Evidence of Coverage for the list of covered services you may receive from out-of-network providers, and the costs for obtaining those services in-network or out-of-network. Before getting services from out-of-network providers you may want to confirm they are accepting Medicare assignment and verify with us that the services you are getting are covered by us and are medically necessary. Certain covered services may only be received from network providers. Please note: While you can get your care from an out-of-network provider, the provider must be eligible to participate in Medicare. Except for emergency care, we cannot pay a provider who has opted out of or been excluded or precluded from the Medicare Program. If you go to a provider who is not eligible to participate in Medicare, you will be responsible for the full cost of the services you receive. Check with your provider before receiving services to confirm that they are eligible to participate in Medicare.
In cases where out-of-network providers submit a bill directly to the enrollee, you should not pay the bill but should submit it to the plan for processing and determination of enrollee liability, if any.
You may get covered emergency medical care whenever you need it, anywhere in the United States and its territories. Our plan covers ambulance services in situations where getting to the emergency room in any other way could endanger your health. For more information, see Chapter 4 of your Evidence of Coverage.
You must use network providers except in emergency or urgent care or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers, neither Medicare nor GlobalHealth will be responsible for the costs.