DR. MARCELLA RAE WOICZIK M.D.
Accepted Insurance for NPI 1053408708
Orthopaedic Surgery - Pediatric Orthopaedic Surgery in El Paso, TX

NPI Status: Active since October 06, 2006

Contact Information

5400 ALAMEDA AVE BLDG B
EL PASO, TX
ZIP 79905
Phone: (915) 242-8402
Fax: (915) 242-8404

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with DR. MARCELLA RAE WOICZIK M.D., a practicing orthopaedic surgery professional in El Paso, TX. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 529 individual coverage options managed by medical networks, including networks like Blue Cross and Blue Shield of Texas, Molina Healthcare, and Select Health. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

Fitler by Network Type

Blue Cross and Blue Shield of Texas

Blue Advantage Bronze HMO? 204
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046055433602TX046070533602TX046070633602TX046070733602TX046070833602TX046070933602TX046071033602TX046071133602TX046071233602TX046071333602TX046071433602TX046071533602TX046071633602TX046071733602TX046071833602TX046071933602TX046072133602TX046072233602TX046072333602TX046072433602TX046072533602TX046072633602TX046072733602TX046072833602TX046086933602TX046107333602TX0461074
Blue Advantage Bronze HMO? 301
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046078233602TX046078333602TX046078733602TX046079233602TX046079333602TX046079433602TX046079533602TX046079733602TX046079933602TX046080133602TX046080233602TX046080333602TX046080433602TX0460806
Blue Advantage Bronze HMO? Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046103333602TX046103433602TX046103533602TX046103633602TX046103733602TX046103833602TX046103933602TX046104033602TX046104133602TX046104233602TX046104333602TX046104433602TX046104533602TX046104633602TX046104733602TX046104833602TX046104933602TX046105033602TX046105133602TX046105233602TX046105333602TX046105433602TX046105533602TX046105633602TX046105733602TX046105833602TX0461079
Blue Advantage Gold HMO? 206
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046054833602TX046055533602TX046055633602TX046055733602TX046055833602TX046055933602TX046056033602TX046056133602TX046056233602TX046056333602TX046056433602TX046056533602TX046056633602TX046056733602TX046056833602TX046056933602TX046057133602TX046057233602TX046057333602TX046057433602TX046057533602TX046057633602TX046057733602TX046057833602TX046086333602TX046106133602TX0461062
Blue Advantage Gold HMO? 603
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046080933602TX046081433602TX046081933602TX046082033602TX046082133602TX046082233602TX046082433602TX046082633602TX046082833602TX046082933602TX046083033602TX046083133602TX046083333602TX0460860
Blue Advantage Gold HMO? Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046092533602TX046092833602TX046092933602TX046093033602TX046093133602TX046093233602TX046093333602TX046093433602TX046093533602TX046093633602TX046093733602TX046093833602TX046093933602TX046094033602TX046094133602TX046094233602TX046094333602TX046094433602TX046094533602TX046094633602TX046094733602TX046094833602TX046094933602TX046095033602TX046095133602TX046095233602TX0460953
Blue Advantage Plus Bronze? 303
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000233602TX087003833602TX087003933602TX087004033602TX087004133602TX087004233602TX087004333602TX087004433602TX087004533602TX087004633602TX087004733602TX087004833602TX087004933602TX087005033602TX087005133602TX087005233602TX087005333602TX087005433602TX087005533602TX087005633602TX087005733602TX087005833602TX087005933602TX087006033602TX087006133602TX087006233602TX0870063
Blue Advantage Plus Bronze? 305
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000333602TX087006433602TX087006533602TX087006633602TX087006733602TX087006833602TX087006933602TX087007033602TX087007133602TX087007233602TX087007333602TX087007433602TX087007533602TX087007633602TX087007733602TX087007833602TX087007933602TX087008033602TX087008133602TX087008233602TX087008333602TX087008433602TX087008533602TX087008633602TX087008733602TX087008833602TX0870089
Blue Advantage Plus Bronze? Standard
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000433602TX087009033602TX087009133602TX087009233602TX087009333602TX087009433602TX087009533602TX087009633602TX087009733602TX087009833602TX087009933602TX087010033602TX087010133602TX087010233602TX087010333602TX087010433602TX087010533602TX087010633602TX087010733602TX087010833602TX087010933602TX087011033602TX087011133602TX087011233602TX087011333602TX087011433602TX0870115
Blue Advantage Plus Gold? 203
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000533602TX087011633602TX087011733602TX087011833602TX087011933602TX087012033602TX087012133602TX087012233602TX087012333602TX087012433602TX087012533602TX087012633602TX087012733602TX087012833602TX087012933602TX087013033602TX087013133602TX087013233602TX087013333602TX087013433602TX087013533602TX087013633602TX087013733602TX087013833602TX087013933602TX087014033602TX0870141
Blue Advantage Plus Gold? 803
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087001133602TX087027233602TX087027333602TX087027433602TX087027533602TX087027633602TX087027733602TX087027833602TX087027933602TX087028033602TX087028133602TX087028233602TX087028333602TX087028433602TX087028533602TX087028633602TX087028733602TX087028833602TX087028933602TX087029033602TX087029133602TX087029233602TX087029333602TX087029433602TX087029533602TX087029633602TX0870297
Blue Advantage Plus Gold? Standard
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000633602TX087014233602TX087014333602TX087014433602TX087014533602TX087014633602TX087014733602TX087014833602TX087014933602TX087015033602TX087015133602TX087015233602TX087015333602TX087015433602TX087015533602TX087015633602TX087015733602TX087015833602TX087015933602TX087016033602TX087016133602TX087016233602TX087016333602TX087016433602TX087016533602TX087016633602TX0870167
Blue Advantage Plus Silver? 202
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000733602TX087016833602TX087016933602TX087017033602TX087017133602TX087017233602TX087017333602TX087017433602TX087017533602TX087017633602TX087017733602TX087017833602TX087017933602TX087018033602TX087018133602TX087018233602TX087018333602TX087018433602TX087018533602TX087018633602TX087018733602TX087018833602TX087018933602TX087019033602TX087019133602TX087019233602TX0870193
Blue Advantage Plus Silver? 605
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087000933602TX087022033602TX087022133602TX087022233602TX087022333602TX087022433602TX087022533602TX087022633602TX087022733602TX087022833602TX087022933602TX087023033602TX087023133602TX087023233602TX087023333602TX087023433602TX087023533602TX087023633602TX087023733602TX087023833602TX087023933602TX087024033602TX087024133602TX087024233602TX087024333602TX087024433602TX0870245
Blue Advantage Plus Silver? Standard
POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX087001033602TX087024633602TX087024733602TX087024833602TX087024933602TX087025033602TX087025133602TX087025233602TX087025333602TX087025433602TX087025533602TX087025633602TX087025733602TX087025833602TX087025933602TX087026033602TX087026133602TX087026233602TX087026333602TX087026433602TX087026533602TX087026633602TX087026733602TX087026833602TX087026933602TX087027033602TX0870271
Blue Advantage Security HMO? 200
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046055233602TX046065533602TX046065633602TX046065733602TX046065833602TX046065933602TX046066033602TX046066133602TX046066233602TX046066333602TX046066433602TX046066533602TX046066633602TX046066733602TX046066833602TX046066933602TX046067133602TX046067233602TX046067333602TX046067433602TX046067533602TX046067633602TX046067733602TX046067833602TX046087233602TX046107733602TX0461078
Blue Advantage Silver HMO? 205
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046055333602TX046068033602TX046068133602TX046068233602TX046068333602TX046068433602TX046068533602TX046068633602TX046068733602TX046068833602TX046068933602TX046069033602TX046069133602TX046069233602TX046069333602TX046069433602TX046069633602TX046069733602TX046069833602TX046069933602TX046070033602TX046070133602TX046070233602TX046070333602TX046086733602TX046106933602TX0461070
Blue Advantage Silver HMO? 801
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046108333602TX046109033602TX046109433602TX046109933602TX046110033602TX046110133602TX046110233602TX046110433602TX046110533602TX046110733602TX046110833602TX046110933602TX046111033602TX0461112
Blue Advantage Silver HMO? Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BLUE-ADVANTAGE-HMO Tier

Accepted Plan ID Variations

33602TX046092633602TX046095433602TX046095533602TX046095633602TX046095733602TX046095833602TX046095933602TX046096033602TX046096133602TX046096233602TX046096333602TX046096433602TX046096533602TX046096633602TX046096733602TX046096833602TX046096933602TX046097033602TX046097133602TX046097233602TX046097333602TX046097433602TX046097533602TX046097633602TX046097733602TX046097833602TX0460979

Molina Healthcare

Molina Gold Core 1640
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0010001
Molina Gold Core 1640 Plus with Adult Dental and Vision
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0060001
Molina Gold Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0010008
Molina Silver Core
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0010002
Molina Silver Core Plus with Adult Dental and Vision
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0060002
Molina Silver Core Plus with Adult Vision
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0040002
Molina Silver Saver with Four Free PCP Visits
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0010010
Molina Silver Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

18167UT0010009

Select Health

Med Benchmark Expanded Bronze Select Copay Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200010
Med Benchmark Expanded Bronze Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200019
Med Benchmark Gold Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200017
Med Benchmark Platinum
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200035
Med Benchmark Platinum Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200037
Med Benchmark Silver 6000 Medical Deductible w/Vision
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0210001
Med Benchmark Silver Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200018
Med Gold 1500 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0020007
Signature Benchmark Gold
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200030
Signature Benchmark Gold Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200022
Signature Benchmark Silver 5900 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200014
Signature Benchmark Silver Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200023
Value Benchmark Expanded Bronze Select Copay Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200009
Value Benchmark Gold Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200020
Value Benchmark Platinum
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200034
Value Benchmark Platinum Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200038
Value Benchmark Silver 5900 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200007
Value Benchmark Silver Standardized Plan
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0200021
Value Expanded Bronze 6900 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0020025
Value Gold 1500 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0020023
Value Silver 3000 Medical Deductible
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

68781UT0020024

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080031
UHC Bronze Essential ($0 Virtual Urgent Care)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080045
UHC Bronze Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080015
UHC Bronze Standard+ (Dental + Vision)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0090005
UHC Gold Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080028
UHC Gold Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0090002
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080055
UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0090008
UHC Gold Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080024
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080026
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0090001
UHC Silver Standard
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080020
UHC Silver Value ($0 Virtual Urgent Care)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0080025
UHC Silver Value+ ($0 Virtual Urgent Care, Dental + Vision)
HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

40220TX0090004

University of Utah Health Plans

Healthy Premier Bronze HSA
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060003
Healthy Premier Expanded Bronze Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060021
Healthy Premier Gold Copay Office Visits
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060001
Healthy Premier Gold Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060019
Healthy Premier Silver Copay Office Visits
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060002
Healthy Premier Silver Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060020
U Health Plus Bronze
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060024
U Health Plus Expanded Bronze Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060027
U Health Plus Gold
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060022
U Health Plus Gold Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060025
U Health Plus Silver
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060023
U Health Plus Silver Standard
EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

42261UT0060026
No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

This provider accepts health insurance plans managed by the following insurance companies: Blue Cross and Blue Shield of Texas, Molina Healthcare, Select Health, UnitedHealthcare, University of Utah Health Plans. You can filter specific policies or search for unique plans using the open dashboard controls located above.
No, current public enrollment indicators show that this provider does not accept standard Medicare program assignments.
DR. MARCELLA RAE WOICZIK M.D. is enrolled across the following managed care network types: EPO, HMO, POS.
  • HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
  • EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.
  • POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.