Health care under the UIChoice plan is available through levels 1, 2, and 3 providers. You do not need to pick a plan level before receiving care from a provider. The lower the provider level you visit, the lower the out-of-pocket costs for the UIChoice member.
UIChoice Provider Levels
Level 1 Providers
Level 1 providers under UIChoice include the University of Iowa Hospital and affiliated clinics, UI Health Care Medical Center Downtown, UI Urgent Care, UI QuickCare, Washington County Hospital and Clinics, and The Iowa Clinic in Des Moines.
- Providers at the University of Iowa Hospitals & Clinics
Medical residents and medical students are an integral part of the team that supports treatment by the faculty and physicians on staff. When care is provided at the University of Iowa Hospital and Clinics, the individual and the provider will agree on the medical residents' role in their care. An individual may choose to have all primary health care provided by faculty members and staff physicians.
Level 2 Providers
This level includes providers in Iowa and parts of South Dakota. They will be listed when you use the "XQW" prefix to search on Wellmark. They would be considered for participation in the Wellmark Blue Cross and Blue Shield (BC/BS) and the Blue POS (UIChoice) network.
Levels 1 and 2 providers are combined under the same out-of-pocket maximum.
- 2025 Levels 1 and 2 providers OPM = $2,000 single/$4,000 family
Level 3 Providers
This level would include any other providers not found when using the "XQW" prefix on Wellmark's website – and could be participating with BCBS or non-participating with BCBS subject to balance billing beyond any coinsurance that the member may owe.
Participating or non-participating Level 3 providers are under a separate out-of-pocket maximum from Levels 1 and 2.
- 2025 Level 3 provider OPM = $2,500 single/$5,000 family
To find instructions on how to search for providers, visit How to Search for a Provider. The member should follow up with Wellmark regarding any additional questions.
Care Providers by Level
Provider Category | Level 1 Providers | Level 2 Providers | Level 3 Providers | |
---|---|---|---|---|
Description | UI Hospital and affiliated clinics, UI Health Care Medical Center Downtown, UI QuickCare, UI Urgent Care, Washington County Hospital & Clinics, and The Iowa Clinic, Des Moines | Blue POS network providers that are not included in Level 1. | Participating providers from the BlueCard network. Non-participating providers outside of the network (subject to balance billing) | |
Provider | BCBS has contracts with these providers, and they agree to accept payment arrangements. | BCBS may or may not have contracts with these providers. | ||
Claim Settlement | These providers file claims for you. Claims are settled directly with these providers. | These providers are not responsible for filing claims for you. You may have to file your claims. Claims are settled with you, not the providers. |
How to find providers on Wellmark.com
Wellmark links to search for a provider
- Wellmark Find a Provider | Blue POS Network
- When searching for providers on the Wellmark website, you use the "XQW" prefix.
- National Provider Locator (outside of Iowa and South Dakota)
- Select BlueCard Traditional from the Choose Your Network dropdown menu.
- BC International Provider Locator
Virtual Care via Doctor on Demand is free for UIChoice members.
How to find providers on Wellmark.com
Searching for a provider in your area
Wellmark Blue Cross and Blue Shield (BCBS) of Iowa's web page will allow you to search for providers in the Blue POS Network (UIChoice) and the Blue HMO Network (UISelect). The networks are the same; both can be searched using the prefix ‘XQW.’
Searching for a provider in your area
From the main Wellmark.com webpage:
- Begin on Wellmark's website.
- Find the Member Resources tab and select the arrow to show a dropdown menu. From the menu, select the link labeled "Find a Provider."
- You should now be on the "Find an in-network health care provider" page.
- Select the blue button labeled "Search Now," and you will see a pop-up box that states, "You are now leaving Wellmark.com." Select the blue button, "Continue to New Site."
- You should now see a blue section with a microscope. Select the white button labeled "Choose a location and plan."
- On the next screen, you can enter an address, a city, a zip code, or even allow the site to use your current location to begin your search. Once entered, the site will ask you if what is pulled up is correct. If so, select the green button.
- You should now see a picture of a BCBS ID card with three boxes underneath. Enter “XQW” for UIChoice or UISelect, and select the green "Continue" button.
- The next page is where you can search by:
- Providers by name, providers by specialty (e.g., primary care provider, OB/GYN, mental health, or telehealth), places by name, places by type, or even search all if needed.
Searching for a national provider
The National Provider Locator (outside of Iowa and South Dakota) can be used to search for Level 3 providers under UIChoice - and for providers outside of Iowa and South Dakota in the case of an emergency or for those with a Guest Membership under UISelect.
The BlueCard Traditional network is used for UIChoice and UISelect to search outside Iowa.
- Go to Wellmark's National Provider Locator page
- Choose a location
- Select a plan - select by plan name (do NOT use the prefix XQW), use “Or, select by plan name”
- Select “BlueCard Traditional” (this is the network used when searching outside of Iowa and South Dakota)
- Select "Indemnity Network" to find participating Level 3 providers. Do not use the prefix XQW.
- Type a name or phrase to find doctors, hospitals, and more
Searching for providers while traveling internationally or living abroad
You take your healthcare benefits abroad as a Blue Cross and Blue Shield member. You can access doctors and hospitals worldwide through the Blue Cross Blue Shield Global® Core program.
- Always carry your current member ID card.
- Before you travel, contact BCBS of Iowa for coverage details. Coverage outside the United States may be different.
- Call the Service Center for Blue Cross Blue Shield Global Core at 1-800-810-2583 to locate a doctor or hospital. If necessary, an assistance coordinator and a medical professional will arrange a physician appointment or hospitalization.
- Call the Service Center to arrange direct billing if you need inpatient care. In most cases, you should not pay upfront for inpatient care except for the out-of-pocket expenses (non-covered services, deductible, copay, and coinsurance) you usually pay. The hospital should submit the claim on your behalf.
- You may need to pay upfront for outpatient and doctor care or inpatient care not arranged through the Service Center. Complete a Blue Cross Blue Shield Global Core International claim form and send it with the bill(s) to the Service Center (the address is on the form). You can also submit your claim online or through the Blue Cross Blue Shield Global Core mobile app. The claim form is available from Wellmark BCBS of Iowa or online at www.bcbsglobalcore.com.
- In an emergency, go directly to the nearest hospital.
To learn more about Blue Cross Blue Shield Global Core:
- Visit www.bcbsglobalcore.com.
- Use the Blue Cross Blue Shield Global Core app from your smartphone.
- Call Wellmark BCBS of Iowa.
- Call the Service Center at 1-800-810-2583, 24 hours a day, seven days a week.
The Blue Cross Blue Shield Global Core program was formerly known as BlueCard Worldwide®. - In addition to contacting the Service Center, call Wellmark BCBS of Iowa for pre-certification or pre-authorization. Refer to the phone number on the back of your member ID card. Note: This number is different from the phone number listed below.
Additional provider information and definitions
Additional Provider Information and Definitions
What is a specialist?
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent, or treat specific symptoms and conditions. (e.g., allergist, cardiologist, dermatologist, neurologist, ophthalmologist, orthopedics)
A non-physician specialist is a provider with more training in a specific area of health care. (e.g., chiropractor, physical therapist, speech pathologist, occupational therapist)
Are there any age restrictions when using Doctor on Demand?
There are times with specific populations where it could be more likely that Doctor on Demand would advise the person to seek in-person care due to potential complications, for example, a newborn or an older adult with multiple health issues. However, in general, there are no specific age restrictions.
*NOTE: Another resource available exclusively to Wellmark members is BeWell 24/7. Health Care professionals can help answer your questions. In addition, the member can find the phone number on their health insurance card.
Difference between participating and non-participating providers
Participating vs. Non-Participating Providers
In Iowa, participating providers will accept payment arrangements and file claims for you with BCBS. Payment is made directly to these providers.
Non-participating providers do not have contracts with BCBS. They do not agree to accept payment arrangements and are not responsible for filing claims for you. Non-participating providers may charge more for health care than participating providers. Payment is made to you from Wellmark, and you are responsible for paying the provider. Non-participating providers can bill you for the difference between what BCBS will pay for a service and what they charge (balance billing).
When you are out of state, using a participating BCBS provider will lower out-of-pocket costs, and the out-of-pocket maximum for Levels 1 and 2 will apply to these providers. In addition, if you receive care in a state that allows balance billing, using a participating BCBS provider should lower the balance bill.
Emergency services
If you receive emergency care for covered services and cannot reasonably reach a participating provider, emergency room care received during the emergency will be reimbursed as though the member obtained the services from a participating provider. In addition, you will be billed a $125 copay, which will be waived if you are admitted.
An emergency is considered a medical condition that a prudent layperson (with an average knowledge of health and medicine) could reasonably expect to seriously jeopardize a person’s health without immediate medical attention. Therefore, emergency services must be provided to the member in an emergency room (not an urgent care center or physician’s office).
Health care while away from Iowa
Out of State
If you are in a state other than Iowa and require medical care, you may call Wellmark BCBS of Iowa at (800) 810-BLUE (2583) for assistance in locating the closest participating provider in that state. You can also find providers in other states through the Wellmark website. For covered services received in a state other than Iowa, there are advantages to using providers who participate in the BCBS plan in that state.
Out of Country
Suppose it is necessary to receive covered services in a country other than the United States. In that case, it is advisable to contact BCBS for assistance locating the closest participating provider in that country.
Have a Question?
ABOUT OUR SITE:
The information presented on our website describes only the highlights of the plans and does not constitute official plan documents. Additional terms and conditions may apply. If there are any discrepancies between the information contained herein and the official plan documents, the plan documents will govern. For more detailed information you may contact Wellmark Blue Cross/Blue Shield at toll-free number 800-524-9242 (TTY: 888-781-4262), Monday through Friday from 7:30 a.m. to 5:00 p.m. (Central Time). For more efficient service, please have your member ID number handy - it can be found on the front of your card.