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Use Tier 1 Signature Network for lower out of pocket costs

Are you making the most of the YNHHS Medical Plan? The plan has three tiers, but the Tier 1 Signature Network includes coverage from select providers, healthcare facilities and services to coordinate your care while meeting your needs and your budget. You aren’t limited to sticking with any one tier throughout the year. However, employees and their dependents who use clinicians and facilities in the Tier 1 Signature Network enjoy lower co-pays, lower out-of-pocket costs, and zero deductibles. (See table 1 for Tier 1 Signature Network clinician and facility categories.)

The best way to minimize out-of-pocket expenses is to know before you go to a doctor or other medical appointment. Remember: 

  • To take advantage of the lowest out-of-pocket costs, use a Tier 1 Signature Network provider and a Tier 1 Signature Network facility for services. 
  • Providers in the same practice may not all be included in the YNHHS Medical Plan’s Tier 1 Signature Network. Check the list of providers before your visit.

Four things to keep in mind:

  • New providers are added throughout the year. Updates to the list can take time to process. Know that until the name is reflected on the Tier 1 list, visits and services will be processed as Tier 2. Contact a Patient Resource Coordinator (PRC) if you have questions about a provider’s status. Call 1-844-543-2147 (option 3) Monday through Friday, 8:30 am – 5 pm, or email [email protected] You can also check the Tier 1 network list online at ynhhsbenefitsconnection.org (search Tier 1) or visit HRConnect.
  • Providers must be participating with Anthem CT before they can be added to our Tier 1 Signature Network. Providers that only participate with Empire Blue Cross (NY), Blue Cross Blue Shield of Rhode Island or Blue Cross Blue Shield of Massachusetts are not considered Tier 1.
  • If you or a covered dependent have a question about a copay or bill, contact the PRC. They will work to adjust incorrect bills and arrange for refunds when appropriate.
  • Anthem’s representatives cannot access the YNHHS Medical Plan Tier 1 Signature Network list and can only refer to the larger Anthem BCBS network. 

Visit www.ynhhsbenefitsconnection.org for information about the medical plan’s three tiers plus charts that show what you will pay for care and how certain services are covered.

Category

Medical Groups

Primary Care

  • Northeast Medical Group (NEMG)
  • Yale Medicine (YM)
  • Community Medical Group (CMG)
  • Trinity Health of New England and SOHO HEALTH, Trinity’s clinician network
  • WestMed

Specialists

  • Northeast Medical Group (NEMG)
  • Yale Medicine (YM)
  • Community Medical Group (CMG)
  • Trinity Health of New England and SOHO HEALTH, Trinity’s clinician network
  • Medical staff at a Yale New Haven Health System hospital

 

Category

Facility Names

Hospitals

YNHHS:

  • Bridgeport Hospital (including Milford campus)
  • Greenwich Hospital
  • Lawrence + Memorial Hospital
  • Westerly Hospital
  • Yale New Haven Hospital

Trinity Health of New England:

  • Johnson Memorial Hospital
  • Mount Sinai Rehabilitation Hospital
  • St. Francis Hospital
  • Saint Mary’s Hospital

Ambulatory Centers

  • YNHHS-jointly or fully owned
  • Trinity Health of New England - jointly or fully owned

Urgent Care and Walk-in Centers

  • NEMG Urgent Care centers
  • YNHHS Urgent Care centers
  • PhysicianOne Urgent Care
  • Trinity Health of New England-owned

Lab Services and Radiology Facilities

  • YNHHS-owned
  • Trinity Health of New England-owned

Table shows the Tier 1 Signature Network clinician and facility categories. For more information, call a Patient Resource Coordinator at 1-844-543-2147 (option 3).