HealthSmart Network for Out-of-State Insureds

The City of Mesa contracted with HealthSmart to provide an out–of-state network for those health plan members who live outside the state of Arizona to help you and the Employee Benefit Trust save money on your health care needs.

The HealthSmart network includes a variety of doctors throughout the United States, including hospitals, urgent care centers, family practice doctors and specialists.

Members living in Arkansas, Louisiana, Mississippi, New Mexico, Texas, and Tennessee can only use HealthSmart PPO (Not Beech Street) providers to be considered as in-network.  Beech Street PPO does not contract with HealthSmart PPO in these states.

This network is only for those covered persons who regularly live outside Arizona.  It is not for members who normally reside in Arizona who are traveling outside the state. 

For out-of-state plan members who use a HealthSmart provider, your services will be processed at the in-network benefit structure for the plan you selected. For example, if you are enrolled in the Choice Plus (90/10) plan, services rendered by a HealthSmart provider will first be subject to a $200 per person annual deductible, then paid at 90%. You will be responsible for paying this deductible and the 10% coinsurance.

If you use a non-network provider as a Choice Plus member, your services will be processed as out-of-network (subject to a $1000 deductible, then paid at 70%).

Finding a HealthSmart Provider

To find a HealthSmart provider online, go to their website at www.healthsmart.net. Click on the "Search for a Provider" button. In the "Search" box, click on "Yes" to agree to the disclaimer. Enter CM002 as the group number.  The screen will refresh. Under Group Number, click on the CM002 link. Click "Ok" on the pop-up button. This will give you access to search for a provider by zip code, state, tax id, etc.

You can also call HealthSmart directly at 1-800-687-0500 to find a provider.

Tips for Using the HealthSmart Network

• If you have other insurance as your primary carrier (i.e., Medicare), and City of Mesa is secondary, you do not have to use a HealthSmart provider as long as the services rendered are covered by your primary insurance. There may be certain services not covered by a primary insurance that the City of Mesa would consider.  For example, Medicare does not cover physical therapy (heat packs, ultrasound, etc.) rendered by a chiropractor.  For these services to be considered at the in-network benefit, you must choose a HealthSmart chiropractor.
• When you arrive for your appointment, present your HealthSmart card to the provider.  If you did not receive a card, please contact the Employee Benefits Office at (480) 644-2299 or via e-mail at benefits.info@Mesaaz.gov.
• When the provider sends in your claim, it must be sent to the HealthSmart address on the card – not to City of Mesa. HealthSmart will reprice the claims (i.e., apply the appropriate discount), then will send them to our office for further processing.
• Providers should still call Employee Benefits at (480) 644-2299 to verify coverage if necessary.  Our office hours are from 7:30 a.m. to 5:00 p.m., Monday – Friday, Mountain Standard Time.

Please remember:  If you are having a surgical procedure or hospitalization, or if you are admitted to the hospital on an emergency basis, these services MUST be pre-certified by American Health Group at (602) 265 3800 or 1 (800) 847-7605.