Provider Networks

Physician Network

The State Health Plan physician network is a participating network, not a preferred provider network. This means all qualified doctors can participate. You may choose your own doctor. Your health plan will pay benefits for medically necessary services whether or not a doctor participates in the network. Network participants agree to accept the State Health Plan's prices as payment in full. This means they won't "balance bill" you – bill you the difference between the State Health Plan's price and what they might normally charge other patients. Network participants also file your claims for you. You'll pay your deductible and coinsurance. 

Hospital Network

South Carolina and Augusta

State Health Plan members have access to every general hospital in South Carolina and Augusta. Network hospitals agree to accept the State Health Plan's prices as payment in full. This means they won't "balance bill" you – bill you the difference between the State Health Plan's price and what they might normally charge other patients. Network hospitals even file your claims for you! You pay the appropriate deductible and coinsurance. We'll cover services you receive at non-network hospitals, too. Just keep in mind, hospitals outside our network can bill you for the difference between the State Health Plan price and their charges.

Out of State

Your health plan covers you if you're traveling out of state and have to go to a hospital for an emergency. It also covers you for certain services you receive at an out-of-state hospital if it's not practical for you to get the services at a network hospital. Certain out-of-state hospitals have notified the State Health Plan that they will accept the State Health Plan prices in all cases. In these cases, you would pay your deductible and coinsurance.