PPO Coverage (Copay Plan)

Tier 1 –   Covers Mercyhealth providers- Click here (select Mercyhealth Partners EPO)

Tier 2- Providers that are not Tier 1 providers but are found in the First Health complementary network of providers First Health network- Click here. When you use this level of benefits, you pay a greater share of the cost of health care services you receive. This level of benefit is described in the Tier 2 Benefits column of the Schedule of Benefits.

Please be aware that even though the following providers/hospital groups may be found on the First Health complementary website, they are not available to you as a Tier 2 provider: Aurora Health Care, Beloit Health System, SSM Health (formerly Dean Health System/St. Mary’s Hospital and Monroe Clinic), OSF HealthCare System, Swedish American Health System.

Tier 3 –  A Tier 3 provider is any provider who is not listed in the MercyCare Provider Directory or on the First Health complementary website (excluding those providers listed above). When you use this level of benefits, you pay the greatest share of the cost of health care services you receive. Tier 3 benefits are subject to usual and customary charge limitations. This tier of benefit is described in the Tier 3 benefits column of the Schedule of Benefits.

PPO HDHP Coverage

Level 1 –   Covers Mercyhealth providers- Click here (select Mercyhealth Partners EPO) and the First Health network- Click here .

Please be aware that even though the following providers/hospital groups may be found on the First Health complementary website, they are not available to you as a Tier 2 provider: Aurora Health Care, Beloit Health System, SSM Health (formerly Dean Health System/St. Mary’s Hospital and Monroe Clinic), OSF HealthCare System, Swedish American Health System.

Level 2 –  Anyone who is not listed in the MercyCare directory, on the First Health website or the excluded providers above.