Highmark offers grace to members on out-of-network rate

highmarkHighmark Inc. is offering a second chance to members who stray out of network, but just once.

The health insurer will cover care that is provided out of network just once at lower, in-network rates, spokesman Aaron Billger said. But members will be billed at much higher, out-of-network rates for subsequent visits to a provider who’s not part of the Highmark network.

Highmark said the Blues licensee had 1.1 million commercial and national members in western Pennsylvania for the 12 months ending in January. Although an exact number was not available, Highmark said only about 2 percent of its members were not able to see UPMC doctors at in-network rates.

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