In most cases, the services you receive must be from a provider in Neighborhood INTEGRITY’s network. Sometimes you may need care from a provider who is not in our network. There are some exceptions as to when you can receive care from an out-of-network provider and services will be covered. Those exceptions are:
- Any emergency or urgently needed care that you receive from an out-of-network provider.
- Kidney dialysis services received at a Medicare-certified dialysis facility when temporarily outside of Rhode Island.
- Family planning services.
- The Continuity of Care (COC) period. The COC period is for members who were receiving a treatment or seeing a provider prior to having coverage with Neighborhood. Even if the provider or service is not within the network it would be covered during the COC period.
- During a declared disaster.