Coverage for out-of-area employees + family

What you need to know

Out of area coverage

If you or a covered family member lives outside the SSM Health service area, you might be eligible to have your medical claims covered as out-of-area.

To find out more or search for providers visit First Health.

Find out how to search for a First Health provider.

Eligibility by zip code

To determine eligibility, review the list of SSM Employee Health Plan network zip codes to determine if you or your dependents qualify as out of area. If your home zip code is not listed, complete the Out-of-Area form.

If you have questions about this coverage, contact member services at 1-877-274-4693.

See out-of-area employee/family form

See out-of-area dependent form

Traveling? You've got coverage

Need health care while your traveling? SSM Health employee health plan members are covered for both urgent and emergency care worldwide. It doesn't matter where you travel, you don't have to worry about health care coverage on vacation. We have you covered. When you need care, visit providerlocator.firsthealth.com to find a provider where you are.

Your coverage

If you need emergent care outside the service area and are unable to get to a plan provider, please go to the nearest urgent care* or emergency center for treatment. It is important to notify us as soon as possible by calling the member services at 1-877-274-4693 (TTY: 711).
All follow-up care should be done by a plan provider. If you are out of the area and unable to see a plan provider, call your primary care practitioner for a referral to an out-of-area provider. These services require approval by us.

*Urgent care coverage is not covered out of network unless it’s an emergency. See your plan document for more information.