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CommercialCoverageMedium impact

Extended Networks

EmblemHealth·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth and ConnectiCare have expanded their extended network partnerships with QualCare and First Health to provide in-network coverage for members in specific geographic areas. QualCare coverage applies to New Jersey only, while First Health Network coverage applies to all states except Connecticut, specific Massachusetts counties, New Jersey, and specific New York counties.

Action Required

Action needed
Immediately: Billing team must update their network verification process to check for extended network coverage. Verify if patients with EmblemHealth or ConnectiCare have QualCare coverage (New Jersey only) or First Health Network coverage (available in most states with geographic restrictions). Update eligibility verification procedures to include these extended networks to ensure proper in-network billing and patient cost-sharing.

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