Insurance Information
Our Insurance Partners
We participate in the following insurance plans:
- AETNA: Some Plans Require Referral
- Includes: Aetna administrators, Advantra Cares (PA residence), Advantra Choice, First Health, HMO, Mailhandlers, Meritain, Open Access (Bronze, Silver & Gold), PEBTF, POS, PPO, QPOS, Savings Plus, Select, Signature, SRC
- BLUE SHIELD: Plans with “PPO Suitcase” Some Plans Require Referral
- Includes: Blue Shield Alliance Flex (Standard Tier Copays), Chip PPO Plus, Community Blue (Enhanced Tier Copay), Federal Employees Program (FEP), Freedom Blue PPO (Higher Member Responsibility), Capital Blue Cross (Tower Health Tier 1 Copay), Highmark Wholecare Medicare
- CIGNA
- Includes: American Postal Workers Union (APWU), Cigna Medicare (Bravo, Cigna True Choice), Great West, NALC, PPO
- Devon Health
- Devoted Health – Delaware Members as of 7/1/24
- Jefferson Health Plans (Formerly HealthPartners) Medicare – NONPAR Divisions: DYT, VFEN
- Humana: Some Plans Require Referral
- 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*
- Intergroup/Beech Street PPO
- Keystone First: Written Script Required
- Keystone First Community HealthChoices: Written Script Required
- Medical Assistance – PA Department of Welfare (PA Access Card)
- Medicare / RailRoad Retirement Board Medicare
- Multiplan PPO / Private Healthcare Systems (PHCS)
- PA Health & Wellness Medicare (Wellcare by Allwell)
- Provider Partners Health Plans Medicare (PPHP)
- TRICARE: Tricare Prime Requires Referral
- Includes: Tricare East, For Life, Prime, Region
- Members with Tricare as their primary insurance will pay the highest out of pocket on their plan.
- Veterans Affairs Optum Requires Authorization
- UNITED HEALTHCARE: Some Plans Require Referral
- Includes: AARP, All Savers, American Postal Workers Union (APWU), Charter, Compass, Core, Golden Rule *Must have UHC Logo*, Oxford Plans *Must have United Choice*, UHC of New York (Empire), UHC One, UMR, UHC Community
- UPMC: Some Plans Require Referral
- Includes: EPO, HMO, Medicare, POS, PPO
- NONPAR Division: CCOAA, DYT
- NONPAR MEDICAL ASSISTANCE (MA)
- Includes: Aetna Better Health, AmeriChoice, AmeriHealth Caritas, Geisinger Family Medicaid, HealthPartners Medicaid, Highmark Wholecare Medicaid, Highmark Options of Delaware, Horizon NJ Health, Mediplus, Out-of-State MA, PA Health & Wellness Medicaid, Unison, UPMC For You
To confirm if we are in-network with your plan, please call us or contact your insurance provider.
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.
To confirm if we are in-network with your plan, please call us or contact your insurance provider.