The WellFirst Health — provided by SSM Health Plan — Medicare Advantage plans service area includes Madison and St. Clair County, IL, and St. Charles, St. Louis County and St. Louis City, MO. You must live in one of these areas to join a WellFirst Health Advantage plan.
Out-of-network/non-contracted providers are under no obligation to treat WellFirst Health members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.