Network providers are the doctors and other health care professionals, medical groups, hospitals, and other health care facilities that have agreed to accept our payments and CDPHP Medicare Choices plan cost-sharing as payment in full. We have arranged for thousands of providers to deliver covered services to our CDPHP Medicare Choices members.
Why Do You Need to Know Which Providers are Part of Our Network?
For HMO plan members, it is important to know which providers are part of our network because, with limited exceptions, while they are a member of our plan they must use network providers to get medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, when they are out of the area), out-of-area dialysis services, and cases in which we authorize use of out-of-network providers.
PPO plan members can choose to receive care from out-of-network providers. Our plan will cover services from either in-network or out-of-network providers, as long as the services are covered benefits and medically necessary. However, when PPO plan members use an out-of-network provider, their share of the costs for covered services may be higher.
To see if your providers are part of the CDPHP Medicare Choices network, access Find-A-Doc or contact us for assistance with locating a provider.
Current CDPHP Medicare Choices members requiring assistance should contact CDPHP member services:
(518) 641-3950 or toll free 1-888-248-6522
Monday – Friday, 8 a.m. to 8 p.m.
Prospective members should contact CDPHP Medicare sales:
(518) 641-3400 or toll free 1-888-519-3364
Our hours are 8 a.m. - 8 p.m. seven days a week, October 1 – February 14. From February 15 – September 30, Monday – Friday, our hours are 8 a.m. - 8 p.m. A voice messaging service is used weekends, after-hours, and federal holidays. Calls will be returned within one business day.