Understanding Network Tiers

You work for a health care organization, so it makes sense you’d get a discount on health care. Choosing Banner Health physicians, pharmacies and other facilities provides quality care for you and your family and supports the organization that supports you. Plus, you save money through lower copays or coinsurance. Here’s a look at the three levels of coverage available through the different network tiers.

» Banner Health Network (max savings): You will receive the most coverage at the lowest cost under the plan using the Banner Health Network with Banner Health providers.

 

» Aetna national network (standard savings): You can get care from Aetna network providers at a higher cost share than you would pay in the Banner Health Network. Wherever you are in the country, you’ll be able to find many excellent in-network options.

 

» Out of network: You are free to go to any provider you choose, but if you choose a provider that is not contracted under the Banner Health or Aetna networks, your deductible and coinsurance will be higher, as these are out of network. Out-of-network claims are paid on a Medicare-based fee schedule.

 

» Non-Banner Area: If you live outside a city/state where a Banner facility is located, you will (most likely) be utilizing the Aetna national network, or Tier 2 coverage. Reach out to the Banner Concierge if you have questions about the best network tier for you.

  • $ – Banner Health Network of providers 33% 33%
  • $$ – Aetna’s national network of providers 66% 66%
  • $$$ – All other providers who do not participate in the Banner Health or Aetna provider networks 100% 100%

Stay in network to avoid balance billing.

Out-of-network claims could expose you to balance billing, which is when a provider bills you for the difference between the provider’s charge and the allowed amount.

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