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Member School employees have access to providers nationwide
Did You Know That All edHEALTH PPO Members Enjoy Access to In-Network Providers?
Apr 14

Did you know that all member school faculty and staff have access to in-network healthcare providers regardless of where they live? Employees enrolled in any of edHEALTH’s PPO options can visit network doctors, hospitals, and other healthcare providers throughout the United States. This benefit is particularly helpful as higher education institutions modify their work-from-home and residency policies.

Increase in Out-of-Area Employees

The burst in work-from-home arrangements during the pandemic has changed where and how people work – perhaps permanently. PwC’s March 2021 Pulse Survey found that almost a quarter of employees are considering or planning to move more than 50 miles away from the office; this is on top of the 12% of employees who have already made such a move since the start of the pandemic. Additionally, remote work arrangements allow schools to hire staff from further away.

Schools with New England Health Plan Administrators

Outside of New England, Harvard Pilgrim Health Care uses UnitedHealthcare’s national provider network. Outside of Massachusetts, Rhode Island, and New Hampshire, Tufts Health Plan uses Cigna’s national provider network. Employees are enrolled in either the Cigna Out-of-Area PPO plan or the CareLink plan. This information is on the employee’s ID card. To find a participating provider, employees can:

  • Call the plan’s customer service department
  • Log into their account online or via the plan’s app and use the provider search feature
  • Check the “PPO” box on Harvard Pilgrim Health Care’s website or the “Carelink Plan” or “Cigna PPO Plan” on the Tufts Health Plan website and then search for a provider.

Schools with National Health Plan Administrators

Outside of New England, edHEALTH has access to over 60 carrier-owned and provider-sponsored networks. All of these include national network options, including Aetna, Cigna, and several Blue Cross Blue Shield networks. Using a customized approach, we determine which network best meets the needs of a new member institution. We evaluate various options for network panel scope, how the network and types of care align with the institution’s utilization patterns, and for financial value. These findings are provided to the new member school and their advisor for final network determination. Employees can find participating providers through the plan’s customer service department, website, or by logging into their account.

Employees Show Their Plan Administrator ID Card

When visiting a doctor or hospital, the employee shows their edHEALTH health carrier ID card, which gives the provider the information they need for billing the plan administrator.

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