Network Provider FAQ

You always have the option to use any provider, but it’s important to know how choices can impact your health care costs.

What’s an in-network provider?

To help manage health care costs, you can get discounts on services and medical procedures when you receive care from Avera Health Plans in-network providers. These include physicians, hospitals, facilities and other health care providers participating in the our network.

These in-network benefits are available with more than 2,000 primary care physicians and 4,300 specialists and other health care providers available in your region.

What’s an out-of-network provider?

Out-of-network providers are physicians, hospitals and health care providers not participating in the Avera Health Plans network. If you receive medical care from an out-of-network provider, you’ll pay more for those services. Because this balance will not go toward your in-network deductible, you’ll pay more overall throughout the year.

Current Members

Health Plan Members

If you have an individual or family plan – or are insured with Avera Health Plans through an employer, log in to access your provider directory.

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Medicare Supplement Members

For clinic visits, you can go to any doctor. For outpatient surgery, you must schedule with an Avera-owned or operated network hospital – or an outpatient center that partners with us to provide services.

View Hospital Directory

Shopping for Health Insurance?

It’s important to know what providers are in network when you’re choosing a plan. Check out the Avera Health Plans provider directory to get more and save more when you visit doctors and facilities in our network.

SEARCH PROVIDERS

Note: If you’re looking for a primary care provider, be sure to search using one of these terms: family medicine, general practice, internal medicine, OB/GYN or pediatrics.

Vision, Dental and Prescriptions

The Avera Health Plans online directory does not include vision or dental providers. Please refer to these other resources for details.

In-Network Vision Coverage

We offer vision insurance through VSP. Please check their website for in-network eye doctors in your area.

VSP VISION PROVIDERS

In-Network Dental Coverage

If your plan covers pediatric dental, you can go to any dentist in South Dakota or Iowa – and receive in-network coverage. To see if your plan covers this, log into your member account and refer to your Summary of Benefits and Coverage.

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Prescription Coverage

If you're looking for insurance, you may also want to check how specific medications are covered. Learn more about our Avera Health Plans prescription drug benefits.

PRESCRIPTION COVERAGE

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Have a question or looking to pay your premium? Go to our member resources for answers, benefit information and much more.

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