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.


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.


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.


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.


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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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