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 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.
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.
You can look at your insurance card in Avera MyChart — online or in the mobile app — to see your specific network.
South Dakota: All counties
Iowa: Buena Vista, Cherokee, Clay, Dickinson, Emmet, Ida, Lyon, O’Brien, Osceola, Palo Alto, Plymouth, Sioux, and Woodbury
Nebraska: Antelope, Boyd, Brown, Cedar, Cherry, Cuming, Dakota, Dixon, Holt, Knox, Keya Paha, Madison, Pierce, Rock, Stanton, Thurston, and Wayne
Your plan may include an out-of-area network solution when traveling or residing outside the Avera Health Plans network service area. 1 Check your Summary Plan Description or ID card to see which network (if any) your plan uses.
Expanded Provider Network
If you do not live in our primary service area, you may still have access to care through our expanded provider network.
UnitedHealthcare® Options PPO Network
PPO Only
How to Navigate the Provider Directory
To view the UnitedHealthcare Options PPO Provider Directory visit UnitedHealthcare's Provider Directory.
Select Medical or Behavioral Health based on your needs.
- Medical: Enter your current location, scroll down and select the Options PPO plan, then browse for care by category.
- Behavioral Health: Enter your current location, then browse professionals and treatment centers.
MultiPlan’s PHCS Network
PPO Only
MultiPlan’s PHCS Network Plan applies to Association Health Plans. To view their directory, enter your search request and location to view providers near you.
How to Navigate the Provider Directory
To view MultiPlan’s PHCS Provider Directory visit MultiPlan’s PHCS Provider Directory.
Enter your search request and location to view. From here, you can customize your search further.
NO Out-of-Area Coverage
HMO
NOTE: Although the card instructs providers to send out-of-area claims to UHSS, there is NO out-of-area coverage for members, except in limited situations where required by policy or law.
NO Out-of-Area Coverage
1 Avera Health Plans offers Preferred Provider Organization (PPO) plans and Health Maintenance Organization (HMO) plans. HMO plans offer no out-of-area coverage except in limited situations where required by policy or law.
