Services Not Covered by CBH
An out-of-network provider is a provider that does not have a contract with CBH to provide services to members. There may be a time when you need to use a provider or hospital that is not in CBH’s network. If this happens, you can contact CBH Member Services. CBH will check to see if there is another provider in your area that can give you the same type of care you need. If CBH cannot give you a choice of at least two providers in your area, CBH will cover the treatment by the out-of-network provider.
Getting Care While Outside of CBH’s Service Area
If you are outside of CBH’s service area and have a medical emergency, go to the nearest emergency room or call 911. For emergency medical conditions, you do not have to get approval from CBH to get care.
If you need care for a non-emergency condition while outside of the service area, contact CBH Member Services, which will help you to get the most appropriate care.
CBH will not pay for services received outside of the United States.
You may be eligible to receive services other than those provided by CBH. Below are some services that are available but are not covered by CBH. If you would like help arranging—but not paying for—these services, please contact CBH Member Services.
Medical Assistance Transportation Program
The Medical Assistance Transportation Program (MATP) provides non-emergency transportation to medical appointments and pharmacies, at no cost to you if you need help to get to your appointment or to the pharmacy. The MATP in the county where you live will determine your need for the program and provide the right type of transportation for you. Transportation services are typically provided in the following ways:
- Where public transportation is available, the MATP provides tokens, passes, or reimburses you for the fare for public transportation.
- If you can use your own or someone else’s car, the MATP may pay you an amount per mile plus parking and tolls with valid receipts.
- Where public transportation is not available or is not right for you, the MATP provides rides in paratransit vehicles, which include vans, lift-equipped vans, or taxis. The vehicle will usually have more than one rider with different pick-up and drop-off locations.
If you need transportation to a medical appointment or to the pharmacy, contact the MATP to get more information and to register for services. LogistiCare is the MATP for Philadelphia County; they can be reached at 877-835-7412.
MATP will work with CBH to confirm that the medical appointment you need transportation for is a covered service. CBH works with MATP to help you arrange transportation. You can also contact CBH Member Services for more information.