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Accepted Insurances

While the list of insurances we accept is extensive, it is not exhaustive. Our staff diligently works to verify eligibility, but please note that larger insurance providers such as BCBS, Aetna, and Cigna offer hundreds of individual plans, each with its own network guidelines. As a result, we cannot guarantee that our providers are in-network with every specific plan.

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To ensure coverage, we strongly recommend contacting your insurance provider directly to confirm whether our doctors are considered in-network with your particular plan prior to scheduling an appointment with our office.

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Thank you for your understanding.

Aetna

Advent Health - Health First 

Ambetter *requires referral for certain plans*

Baycare Plus Medicare Advantage HMO

BCBS - Blue Options PPO

BCBS - Network Blue PPO

BCBS - Florida Blue PPC

BCBS - Horizon PPO

BCBS - Independence PPO

BCBS- Anthem PPO

BCBS - Traditional PPS | PHS

BCBS - Federal PPO

BCBS - Empire 

BCBS - Advantage 65 Supplement Plans

Cigna - Baycare Share

Cigna - Open Access Plus

Cigna - PPO

Cigna - Healthgram

Cigna - HMO - POS *requires referral*

Cigna - HMO Open Access

Cigna - HMO Open Access POS 

Cigna - Samba Health

Cigna - Allegiance

Cigna - Emi Health

Devoted - Medicare

CMS - Medicaid

Evolutions Healthcare Systems

Florida Health Solutions

Humana PPO 

Humana HMO *requires referral*

Humana POS 

Humana EPO

Humana MCR PPO

Humana MCR POS

Humana PFFS

Humana Gold Plus MCR HMO *requires referral*

Medicare & Palmetto Railroad Medicare

Molina​

Multiplan | PHCS | Beechstreet

Oscar - PPO

Oscar - POS *requires referral*

Oscar - EPO

Oscar - HMO 

Simply - CHA

Simply - Healthy Kids

Simply - Medicaid

Simply - Medicare

Sunshine - Medcaid

Staywell (now Sunshine) - Medicaid

Tricare for Life

Tricare Select

Tricare Humana Military West

Tricare Humana Military East

 

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*If your insurance plan requires a referral, please note that the referral authorization must come directly from your insurance provider, not from your physician. We must receive the insurance referral authorization before we can schedule your appointment. If you're unsure whether your plan requires a referral, we recommend contacting your insurance provider directly for clarification.*

About Insurance

It can be uncomfortable to talk about our health in terms of cost, but we must. Health insurance is becoming more complex and confusing. So, it can be hard to keep up!

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Often our healthcare is paid through a combination of insurance reimbursement (the portion paid by our insurance) and direct out-of-pocket responsibilities (the portion paid by us as individuals).

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In Network” vs. “Out of Network” 

  • Your insurance coverage and benefits are a contract between you and your insurance company. Therefore, all disputes must be handled between you and your insurance company

 

  • We are contracted with insurers to accept assignment of benefits. If you have insurance coverage under a plan with which we do not have a contract, you will be treated as a “Out of Network” patient.

 

  • We are required to file with your primary insurance carrier only. As a courtesy to our patients, we will file a claim with your secondary insurance. The medical insurance you supply to our office must be accurate and up to date

 

"Deductibles" are a set dollar amount that must be spent by us before our health insurance will begin to cover expenses. For example, if you have a $500 deductible, your insurance requires you to spend $500 on your healthcare first. Only after you have spent this amount will they begin to pay for services. Be aware, plans with low deductibles often have higher monthly premiums while plans with high deductibles often have lower monthly premiums. 

 

"Copays" are a fixed dollar amount you pay for your healthcare services. For example, an office visit may cost $50, but if you have a copay of $20, you will only ever pay $20. 

 

"Co-Insurance" is a certain percentage of cost you pay for your healthcare services. For example, if you have a health plan with 20% co-insurance, then you would pay $10 for an office visit that costs $50. 

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About Insurance

Choose an insurance plan wisely because that determines how much your direct out-of-pocket expenses will be.

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Unfortunately, just because we accept reimbursements from your insurance does not mean we have ready access to all of the details of your insurance benefits. 

 

Feeling surprised by a cost can be upsetting and we very much want to help you avoid surprises as best as we can!

 

Although we will do our very best to guide you, we also encourage you to reach out to your insurance ahead of time to clarify any questions or concerns you may have. They should be an excellent resource for your specific benefits! We are also happy to provide you with common codes billed. 

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