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*If you have difficulty in reading or understanding this information, please contact Paramount Member Services at 419-887-2525 (toll-free 1-800-462-3589) or TTY at 419-887-2526 (toll-free 1-888-740-5670) for help. This information can be provided orally in English, or in your primary language. Written translations may be available in certain languages and accommodations will be made for the visually impaired.

For Paramount Preferred Options members, you can contact Member Services at 419-887-2531 (toll-free 1-866-452-6128). Paramount Care of Michigan members can call 734-529-7800 (toll-free 1-888-241-5604). Paramount Preferred Choices members can contact Member Services at 1-866-380-8900.

All female members are allowed to self-refer to certified nurse midwives (CNMs), obstetricians and gynecologists on Paramount's provider panel. In addition, female members are also allowed to self-refer to women's health specialists on the Paramount panel for routine and preventive health care services if their PCP is not a women's health specialist. For a list of women's health specialists on Paramount's panel, please contact Member Services at 419-887-2525 (toll-free 1-800-462-3589) or TTY at 419-887-2526 (toll-free 1-888-740-5670).

Paramount does not use quality, member experience, patient safety or cost related measures when selecting practitioners or hospitals for participation in the network. Member experience measures are used when re-credentialing network practitioners.

Please be sure you are searching the provider directory that is applicable to your product type. Please also review the statements below as applicable:

HMO: When your doctor recommends a treatment or test, in most cases it will be covered. However, some treatments may not be covered or are covered only when authorized in advance by Paramount. Authorization is based on Medically Necessary guidelines. If a Medically Necessary covered service is not available from any Participating Providers, Paramount will make arrangements for an ‘out of plan Prior Authorization’. Services from a non-participating provider without a Prior Authorization will not be covered. All eligible authorized services will be covered subject to appropriate Deductible and Copayment/Coinsurance. 

CDHP/PPO: You may seek care from Providers outside the Network. For Out-of-Network Hospital Providers in Lucas County, Paramount pays for benefits based on the lesser of the Non-Contracting Amount (NCA) that is determined payable by Paramount of the actual charge for the service. For all other Out-of-Network Hospitals, Physicians/Providers, Paramount pays for benefits based on the lesser of the Usual, Customary, Reasonable (UCR) Charge or the actual charge for the service. There are cases where Paramount has been unable to secure a contract with a hospital-based physician or provider. Please note that services from Out-of-Network hospital-based providers, even though rendered in an In-Network hospital, will be paid under Out-of-Network benefits. Prior Authorization is required for certain procedures and services. If you have a question about whether a service is covered, please call the Member Services Department at (419) 887-2525 Toll Free 1-800-462-3589 TTY (419) 887-2526 TTY Toll-Free 1-888-740-5670.