You are hereRisk Sharing / Health Care / MACoHCT Providers

MACoHCT Providers

Am I required to use preferred providers?

No. As a MACo Health Care Trust participant, you are never required to see providers who are members of Preferred Provider Organizations or networks. Some PPO network logos are displayed on the back of your MACoHCT card, but you can see any licensed provider you choose, even if they are not members of those networks.

Why should I care about preferred provider networks?

Although you are not required to see in-network providers, there are distinct advantages to doing so. For one thing, you know you are getting the best deal possible, thanks to agreements in place with the networks. Also, in-network providers will not bill you for any amount that exceeds the MACoHCT allowable fee, even if they normally would charge more for the service you received. The allowable fee is based on the 90th percentile of "usual, customary and reasonable" (UCR) charges for each service. (Keep in mind that you are always responsible for meeting your plan’s deductible and for paying any required co-payment amount.)

If you see out-of-network providers, those providers may bill you for any amounts that exceed the MACoHCT allowable fees. This is called “balance billing,” and you can avoid it by visiting in-network providers.

Is my doctor a member of the preferred provider network?

Use this link to see if your doctor or if a medical facility is a preferred provider:

Tips for using this link:

  • Participant ID can be found on your MACoHCT ID Card
  • Be sure to check the Disclaimer box
  • Network Providers within the state of Montana can be found in the Allegiance Network
  • Network Providers outside the state of Montana can be found in the Cinga Network