Health care under the UISelect plan is available through Level 1 and Level 2 providers. UISelect does not offer Level 3 providers, except in emergencies or with a guest membership. Levels 1 and Level 2 include only hospitals and clinics in Iowa.

You do not need to pick a plan level before receiving care from a provider. The lower the provider level you visit, the lower out-of-pocket costs for the UISelect member.

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UISelect Provider Levels

Level 1 Providers

Level 1 providers under UISelect include the University of Iowa Hospital and affiliated clinics, UI Urgent Care, UI QuickCare, Washington County Hospital and Clinics, and The Iowa Clinic in Des Moines.

When searching on the Wellmark website for providers, you will use the prefix "XQW."

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 Hospitals and Clinics, the individual and the provider will agree on the role medical residents will play in their care. An individual may choose to have all primary health care provided by faculty members and staff physicians only.

Level 2 Providers

This level includes providers in Iowa and South Dakota (and a few in surrounding states). They will be listed when you use the XQW when performing a search on Wellmark. These providers are considered to participate with Wellmark Blue Cross & Blue Shield, for the Blue Access (UISelect) network. 

Level 3 Providers (not covered)

UISelect does not cover level 3 providers. The only exceptions include emergencies or care with a Wellmark-approved out-of-network referral. (Dependent children attending college, long-term travelers, and families living apart may be covered through guest membership)

Care Providers by Level

Provider Category Level 1 Level 2
Level 3
(Not covered)
Description All UI health care locations, including University of Iowa Hospitals & Clinics, UI Urgent Care, UI QuickCare, Washington County Hospital, and Clinics, and The Iowa Clinic in Des Moines

Providers from the Blue Access network

Locally, Level 2 includes Mercy Hospital and most providers in and around Iowa City that are not Level 1

Not covered, except in emergencies. 

(Dependent children attending college, long-term travelers, and families living apart may be covered through guest membership)
BCBS Payment Arrangements Blue Cross and Blue Shield of Iowa have contracts with these providers, and they agree to accept payment arrangements and file claims for you. Payments are made directly to these providers.
N/A
Claim Settlement These providers will file claims for you. Claims are settled directly with these providers.
N/A

Additional Provider Information and Definitions

 

FAQ's and Info

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. (Examples:  allergist, cardiologist, dermatologist, neurologist, ophthalmologist, orthopedics, etc.)

A non-physician specialist is a provider who has more training in a specific area of health care. (Examples: chiropractor, physical therapist, speech pathologist, occupational therapist, etc.) 

*NOTE:
For UISelect,
chiropractors, physical therapists, speech pathologists, and occupational therapists’ office copay is the same as the office PCP copay.   

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.

Participating vs. Non-Participating Providers

In Iowa, participating providers will accept payment arrangements and file claims for you with Blue Cross and Blue Shield. Payment is made directly to these providers.

Non-participating providers do not have contracts with Blue Cross and Blue Shield. 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 Blue Cross and Blue Shield will pay for a service and what they charge (balance billing).

When you are out of state, using a participating Blue Cross and Blue Shield provider will result in lower out-of-pocket costs for you, and the out-of-pocket maximum for Level 1 and Level 2 will apply to these providers. In addition, if you receive care in a state that allows balance billing, using a participating Blue Cross and Blue Shield provider should lower the balance bill.

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 $100 copay, which will be waived if you are admitted.

An emergency is considered to be a medical condition that a prudent layperson (with an average knowledge of health and medicine) could reasonably expect to result in serious jeopardy to a person’s health in the absence of immediate medical attention. Therefore, the emergency services must be provided to the member in an emergency room setting (not an urgent care center or physician’s office).

Out of State  

UISelect only covers providers within the state of Iowa. If you are outside of Iowa and require non-emergent medical care, you may use the free telehealth Doctor on Demand service for mild illnesses. If you visit a provider that is not within Iowa, the member's services will not be covered unless it is a true emergency situation. Please visit the Emergency Services section above for more details. 

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ABOUT OUR SITE: 
Our website's information 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 the 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, which is on the front of your card.