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Insurance Information

Our Insurance Partners

Aetna
Cigna Healthcare
Tricare
United Healthcare

We participate in the following insurance plans:

  • AETNA: Some Plans Require Referral
    • Includes: Aetna administrators, First Health, HMO, Mailhandlers, Meritain, Open Access (Bronze, Silver & Gold), PEBTF, POS, PPO, QPOS, Savings Plus, Select, Signature, SRC
  • Anthem BCBS of CT: Out of state Plans with “PPO within Suitcase” Some Plans Require Referral
    • BCBS plans without the PPO inside of the suitcase, the patient’s plan is considered out of network and the patient must be notified and asked to pay at the time of service.
  • CarePartners Medicare 
  • CIGNA
    • Includes: American Postal Workers Union (APWU), Cigna Medicare (Bravo, Cigna True Choice), Great West, NALC, PPO
  • ConnectiCare Commercial & Medicare
  • Medicare / RailRoad Retirement Board Medicare
  • TRICARE: Tricare Prime Requires Referral
    • Includes: Tricare East, For Life, Prime, Region – Certified provider, but not in network
    • Members with Tricare as their primary insurance will pay the highest out of pocket on their plan. (15% above allowable amount)
    • Veterans Affairs Optum Requires Authorization
  • UNITEDHEALTHCARE: Some Plans Require Referral
    • Includes: AARP, All Savers, American Postal Workers Union (APWU), Charter, Compass, Core, Golden Rule *Must have UHC Logo*, Medicare Plans, Oxford Plans *Must have United Choice*, UHC of New York (Empire), UHC One, UMR
  • Wellcare Medicare
  • INDEPENDENCE BLUE CROSS: HMO/POS Plans Require Referras
      • Includes: AmeriHealth Administrators, AmeriHealth HMO, AmeriHealth Regional Preferred, DVACO, Independence Administrators, Keystone HealthPlan East (KHPE), KHPE 65, KHPE Focus, KHPE VIP, Personal Choice (PC), PC 65, PC/KHPE Proactive Plans (Bronze, Silver, Gold, Platinum)
      • *Tier 1 Division PENN: CCOAA, Tier 1 Division DYT: DYT, Tier 1 Division Crozer: HNA, Tier 1 Division Einstein: ZENT, Tier 1 Division JEFF: ALL*

Out-of-Network Notice


Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay, and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility bat are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency Services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is for your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist.

Frequently Asked Questions