2018 Miscellaneous Plans
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- Reynard McCormick
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1 2018 PLANS WE DO NOT PARTICIPATE IN Aetna TRS Gold Choice POS II Seton Health Alliance* Amerigroup Amerivantage BCBS Blue Advantage * BCBS CHIP BCBS Empire Plan * Cigna Connect* Humana * IdealCare Scott & White Health Plans (ECEPT EMPLOYEE PLAN) Sendero Health Plans Seton CHIP Seton Health Alliance Superior Health Plans (includes Ambetter) UHC Empire Plan* UHC Community Plan Star Plus (not the Medicare Advantage Plans)* UHC Medicare Advantage Dual Complete Focus * UHC AARP Medicare Advantage Complete Focus * UHC AARP Medicare Advantage Complete Focus Essential * Valuepoint Discount Plan *included in the major insurance plans below* Assurant Health Beechstreet Fair Price Network First Care (/) First Health Coventry Health (/) Galaxy Healthcare Golden Rule Healthsmart Multiplan Oscar PHCS Scott & White EMPLOYEE PLAN ONLY Seton Health Plan (Employee plan) Seton Insurance Co Performance Seton Insurance Co Performance Plus Smarthealth UMR USA Managed Care Organization Vista Miscellaneous Plans
2 2018 Aetna plans 2018 Aetna Employer/Group Plans Aetna Whole Health Seton Health Alliance Aetna Select/Aetna Select Open Access Choice POS Open Access Choice POS II Open Access Elect Choice EPO/Elect Choice EPO Open Access EPO Savings Plus Austin HealthFund Open Access Health Network Option, Health Network Option Open Access / Open Access NAP Managed Choice/Managed Choice Open Access Managed Choice POS Open Access Open Choice Peak Preference Open Access PCP Referral Plan Premier Care Network Premier Care Network Plus Voluntary Plans 2018 Aetna TRS Plans Choice POS II Seton Health Alliance Aetna Select Open Access HSA Seton Health Alliance Aetna Select Open Access *IF CARD DOES NOT HAVE "POS II" WE DO NOT ACCEPT* 2018 Aetna Medicare Advantage Plans Choice Plan Open Access Premier Plan
3 2018 BCBS Plans 2018 BCBS Individual Plans All plans are Blue Advantage for BCBS Employer/Group Plans Blue (Essential is new name) Healthselect BlueChoice Blue Premier PAR Plan Empire Plan BCBS Federal Plan 2018 BCBS Medicare Advantage Plans Medicare Advantage Medicare Advantage POS Medicare Advantage 2018 Cigna Plans Open Access Plus (OAP) Local Plus Connect 2018 Government Plans Medicare Railroad Medicare Tricare Prime Tricare Standard GEHA Medicaid (secondary only)
4 2018 Humana Plans 2018 Humana Employer/Group Plans Choice POS National POS OpenAccess & Open Access Plus Humana Preferred POS Open Access National Premier National EPO Humana Humana Preferred Humana Choice Care Network Humana Choice Care+ Network Humana Preferred Oscar+Humana National Network 2018 Humana Medicare Advantage Plans Gold Plus Employer TRS Care Medicare Advantage Employer Plus Humana Gold Choice Network PFFS
5 2018 United Healthcare 2018 United Healthcare Individual Plans Golden Rule 2018 United Healthcare Employer/Group Plans Charter POS Select Plus POS Navigate Plus POS Core POS Charter Choice Core Select Navigate Plus Signature Value Charter EPO Choice EPO Allsavers Alternative Funding Choice Plus Core EPO Select Plus EPO Navigate Plus EPO The Empire Plan Select NexusACO,, HSA UHC Community Plan Star Plus (not Medicare Advantage plans) 2018 United Healthcare Medicare Advantage Plans Care Improvement Plus Gold Rx Regional SNP Care Improvement Plus Silver Rx Regional SNP Care Improvement Plus Advantage Regional Care Improvement Plus Dual Advantage Regional SNP United Healthcare Dual Complete Focus United Healthcare Dual Complete SNP AARP Medicare Complete AARP Medicare Complete Focus AARP Medicare Complete Focus Essential UnitedHealthcare Group Medicare Advantage UnitedHealthcare Group Medicare Advantage
Group 3. Products Provider Customer Service Internal Use Information
Go to Group 3 Medical Plans (pp 1-5) Go to Group 3 Government Plans (pp 6) Go to Group 3 Plans (pp 6) Go to Group 4 Medical Plans (pp 7-8) Go to Group 4 Government Plans (pp 8-9) Group 3 Products Provider
UC Health Accepted Insurance Plans
INSURANCE CARD TYPICAL NAME PRODUCT TYPE Medical Daniel Drake 3-hab Ohio Worker's Comp ID Card Worker's Comp YES YES YES YES AARP Medicare Complete (underwritten by United Health Medicare Advantage YES
Holy Cross Hospital/Holy Cross Medical Group/POSC Commercial HMO/PPO Plans
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Holy Cross Hospital/Holy Cross Medical Group/POSC Commercial HMO/PPO Plans
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Claims Inquiry Phone # Authorization Process. Fee Schedule Notes. Claims Address
Inquiry ADVANTAGE 360 ( Self-funded) Optional Advantage 360 (call # on ID for add'l (www.advantageplan.com) Terming 12/31/2016 ADVANTAGE Health Solutions HMO Prime ProHealth Risk ProHealth ing P.O. Box
Provider ParticipationList
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NPI# PHYSICAL THERAPY MANAGED CARE BENEFITS/PRIOR AUTHORIZATION. Outpatient Physical Therapy Centers
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Mount Sinai Brooklyn. Beth Israel/ Petrie. Y Y Beacon Y Y Y Beacon. Y Y Beacon Y Y Y Beacon. Y Y Beacon Y Y Y Beacon. Y Y Beacon Y Y Y Beacon
Effective 01/01/2019 Moun St Luke's & West (Roosevelt) 1199 Union ADAP (opd only) NYS HIV program NYS HIV program Aetna U.S.Healthcare Insurance Co. HMO/POS/ Y Y Indemnity Y Y NYC Community Plan Y Y International
2018 Medicare Contracted Plans
GEISINGER HEALTH PLAN H3954-097 GEISINGER GOLD SECURE RX (HMO SNP) $0.00 $37.20 GEISINGER HEALTH PLAN H3954-157 GEISINGER GOLD CLASSIC ADVANTAGE RX $133.30 $49.70 GEISINGER HEALTH PLAN H3954-158 GEISINGER
PARENT NAME CONTRACT/PBP PRODUCT NAME PART C PREM PART D PREM
GEISINGER HEALTH PLAN H3954-097 GEISINGER GOLD SECURE RX (HMO SNP) $0.00 $37.00 GEISINGER HEALTH PLAN H3954-157 GEISINGER GOLD CLASSIC ADVANTAGE RX $130.10 $52.90 GEISINGER HEALTH PLAN H3954-158 GEISINGER
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Effective 01/1/2019 1199 Union PPO ADAP (opd only) NYS HIV program NYS HIV program Y N N Aetna U.S.Healthcare Insurance Co. HMO/POS/PPO Indemnity NYC Community Plan International plans Medicare Student
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CENT Participating Insurances
CENT Participating Insurances 1199 National Benefit Fund 21 st Century Auto Insurance AAA Keystone Insurance AARP AARP Medicare AARP Medicate Advantage Administrative Concepts Administrative Services Aetna
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