IMPORTANT NOTE: Effective August 1, 2013 authorizations will be required for all elective CT, MRI and PET scans. Your doctor is responsible for obtaining the authorization from ExclusiveChoice. You can assist by reminding your provider's office that EC requires authorization for your CT, MRI or PET scan.
Welcome to ExclusiveChoice, a health benefit plan of SSM Health Care. It is through our exceptional health care services that we reveal the healing presence of God. We value the sacredness and dignity of each person. Therefore, we find these five values consistent with both our heritage and ministerial priorities:
Compassion Respect Excellence Stewardship Community
These are the values, beliefs and principles that motivate SSM Health Care.
The ExclusiveChoice plan offers comprehensive health care services through SSM’s extensive network of Hospitals and facilities; including SSM Rehabilitation Hospital, SSM Home Care, and SSM providers in Missouri and Illinois. Utilizing this quality network of providers results in more enhanced benefits and reduced premiums compared to traditional health plans.
Physicians who participate in the ExclusiveChoice plan are members of the SSM Managed Care Organization and must meet a defined set of criteria designed to promote excellence in the delivery of health care services. Please read your employee Summary Plan Description (SPD) carefully for details about the plan coverage and exclusions. SPDs are available from your SSM Health Care Human Resources Department or online by clicking here.
Plan Basics: Members must use in-network providers, except for emergencies, or if services are not available within the network. Plan authorization is required for services from any out-of-network (non-participating) provider.
Members must present their ExclusiveChoice ID cards whenever they access medical care. Applicable co-payments are due at the time of service.
|PCP office visit
|Specialist office visit
|Outpatient PT, ST and OT visit
|Behavioral medicine outpatient visit
|Urgent Care visit
|ER visit (waived if admitted)
There are no co-payments for Preventive Care (well-woman exam, screening mammogram, pap smear, routine immunizations). These services are covered at 100%