Insurance

The following are insurance carriers with which we work to provide you the treatment you need. This may not reflect all insurance accepted by us and is for informational purposes only. Always independently verify insurance coverage, provider participation, and coverage terms. Call (630) 656-2541 to confirm.

Aetna (Out-of-Network)
  • Aetna (Out-of-Network)
Ash Multiplan
  • Ash Multiplan
Blue Cross Blue Shield National
  • BlueCard PPO Basic
  • BlueCard PPO/EPO
  • BlueCard Traditional
Cigna
  • Cigna
Humana
  • Humana
Medicare Traditional
  • Traditional Medicare
Oxford Health Plans
  • Freedom + Choice Plus
  • Garden + Choice Plus
  • Liberty + Choice Plus
  • Metro + Choice Plus
UnitedHealthcare
  • AARP Medicare Advantage (HMO)
  • AARP Medicare Advantage (HMO-POS)
  • AARP Medicare Advantage Access (HMO)
  • AARP Medicare Advantage Choice (PPO)
  • AARP Medicare Advantage Choice (Regional PPO)
  • AARP Medicare Advantage Choice Plan 1 (PPO)
  • AARP Medicare Advantage Choice Plan 2 (PPO)
  • AARP Medicare Advantage Choice Plan 2 (Regional PPO)
  • AARP Medicare Advantage Choice Plan 3 (PPO)
  • AARP Medicare Advantage Choice Premier (PPO)
  • AARP Medicare Advantage Focus (PPO)
  • AARP Medicare Advantage Headwaters (PPO)
  • AARP Medicare Advantage Lakeshore (PPO)
  • AARP Medicare Advantage Open (PPO)
  • AARP Medicare Advantage Patriot (HMO)
  • AARP Medicare Advantage Patriot (HMO-POS)
  • AARP Medicare Advantage Patriot (PPO)
  • AARP Medicare Advantage Patriot (Regional PPO)
  • AARP Medicare Advantage Patriot Plan 1 (PPO)
  • AARP Medicare Advantage Patriot Plan 2 (HMO-POS)
  • AARP Medicare Advantage Plan 1 (HMO)
  • AARP Medicare Advantage Plan 1 (HMO-POS)
  • AARP Medicare Advantage Plan 2 (HMO)
  • AARP Medicare Advantage Plan 2 (HMO-POS)
  • AARP Medicare Advantage Plan 3 (HMO)
  • AARP Medicare Advantage Plan 4 (HMO)
  • AARP Medicare Advantage Plan 5 (HMO)
  • AARP Medicare Advantage Plan 6 (HMO)
  • AARP Medicare Advantage Plan 7 (HMO)
  • AARP Medicare Advantage Plus Plan 1 (HMO-POS)
  • AARP Medicare Advantage Plus Plan 2 (HMO-POS)
  • AARP Medicare Advantage Premier (PPO)
  • AARP Medicare Advantage Prime (HMO)
  • AARP Medicare Advantage Profile (HMO-POS)
  • AARP Medicare Advantage Riverbank (PPO)
  • AARP Medicare Advantage Value (HMO)
  • AARP Medicare Advantage Value (HMO-POS)
  • AARP Medicare Advantage Walgreens (HMO)
  • AARP Medicare Advantage Walgreens (HMO-POS)
  • AARP Medicare Advantage Walgreens (PPO)
  • AARP Medicare Advantage Walgreens Plan 1 (PPO)
  • AARP Medicare Advantage Walgreens Plan 2 (PPO)
  • AARP Medicare Advantage Walgreens Plan 3 (PPO)
  • Assisted Living Plan (PPO ISNP)
  • Base Plan (Choice)
  • Caterpillar
  • Charter HMO/ Charter Balanced HMO/Charter Plus HMO
  • Charter Plus
  • Charter/Charter Balanced
  • Children's Hospital of Colorado
  • Choice
  • Choice Excluding Sutter
  • Choice HMO/Choice Plus HMO
  • Choice Including McLeod
  • Choice OCI
  • Choice Plus
  • Choice Plus Excluding Sutter
  • Choice Plus Including McLeod
  • Choice Plus POS
  • Choice Plus with Harvard Pilgrim
  • Choice with Harvard Pilgrim
  • Core
  • Core Essential
  • Core HMO/Core Essential HMO
  • Doctors Plan
  • Doctors Plan HMO
  • Doctors Plan Plus
  • Dual Complete (HMO DSNP)
  • Dual Complete (HMO POS DSNP)
  • Dual Complete (PPO DSNP)
  • Dual Complete Choice (Regional PPO DSNP)
  • Dual Complete Choice LP (PPO DSNP)
  • Eaton
  • Erickson Advantage
  • Group Medicare Advantage (HMO)
  • Group Medicare Advantage (PPO)
  • HCA Choice Plus
  • HPHC Access America/CH+
  • HPHC Commercial PPO
  • Heritage Plus
  • Heritage Select Advantage (AR/GA/NC/SC/TN)
  • Medica Choice with UHC Choice Plus
  • Medica Choice with UHC Options PPO
  • Medicare Advantage (HMO)
  • Medicare Advantage Assist (PPO CSNP)
  • Medicare Advantage Assure (PPO)
  • Medicare Advantage Choice (PPO)
  • Medicare Advantage Choice (Regional PPO)
  • Medicare Advantage Choice Plan 1 (PPO/Regional PPO)
  • Medicare Advantage Choice Plan 2 (PPO/Regional PPO)
  • Medicare Advantage Choice Plan 3 (Regional PPO)
  • Medicare Advantage Choice Plan 4 (Regional PPO)
  • Medicare Advantage Open/Open Essential/Open Premier (PPO)
  • Medicare Advantage Patriot (HMO)
  • Medicare Advantage Patriot (Regional PPO)
  • Medicare Advantage Plan 1 (HMO)
  • Medicare Advantage Plan 2 (HMO)
  • Medicare Advantage Plan 3 (HMO)
  • Medicare Gold (Regional PPO CSNP)
  • Medicare Silver (Regional PPO CSNP)
  • Methodist Health System Enhanced Plan (Choice Plus)
  • NYU Choice Plus
  • NYU Top Tier
  • Navigate HMO/Navigate Balanced HMO/Navigate Plus HMO
  • Navigate Plus
  • Navigate/Navigate Balanced
  • Nexusaco OA
  • Nexusaco OAB
  • Nexusaco OAP
  • Nexusaco R
  • Nexusaco RB
  • Nexusaco RP
  • Northwell Health Choice
  • Northwell Health Choice Plus
  • Northwell Health Options PPO
  • OHPH UHC Choice Plus POS
  • Options PPO
  • Options PPO Including McLeod
  • Options PPO with Harvard Pilgrim
  • Options Providers Outside Franklin County
  • Passport Connect Choice
  • Passport Connect Choice Plus
  • Qual Health Center Select Plus POS
  • Select
  • Select HMO
  • Select Plus
  • Sutter Core
  • Sutter Options PPO
  • Sutter Select+
  • The Empire Plan
  • Universal Health Services Choice EPO
  • Universal Health Services Choice Plus/Options PPO
  • WellMed Affiliated Provider Choice Plus
  • West Virginia State Employees

Video - Understanding Insurance Coverage

We know that the health payment process can be complex and confusing. Here is an excellent video that explains general concepts about insurance coverage.

Health Insurance Terms

Below, you will see a list of terms that pertain to insurance coverage and payment for health services.

  • Co-insurance: in indemnity, the monetary amount to be paid by the patient, usually expressed as a percentage of charges.
  • Co-payment: in managed care, the monetary amount to be paid by the patient, usually expressed in terms of dollars.
  • Consumer Driven Health Care (CDHC): refers to health plans in which employees have personal health accounts such as a health savings account, medical savings accounts or flexible spending arrangement from which they pay medical expenses directly.
  • Deductible: the portion of medical costs to be paid by the patient before insurance benefits begin, usually expressed in dollars.
  • Denial: refusal by insurer to reimburse services that have been rendered; can be for various reasons.
  • Eligibility: the process of determining whether a patient qualifies for benefits, based on factors such as enrollment date, pre-existing conditions, valid referrals, etc.
  • Exclusions: services that are not covered by a plan.
  • Flexible Spending Arrangements (FSAs): an account that allows employees to use pre-tax dollars to pay for qualified medical expenses during the year. FSAs are usually funded through voluntary salary reduction agreements with an employer.
  • Gatekeeper: in managed care, it refers to the provider designated as one who directs an individual patient's care. In practical terms, it is the one who refers patients to specialists and/or sub-specialists for care.
  • Health Maintenance Organization (HMO): a form of managed care in which you receive your care from participating providers.
  • Health Savings Account (HSA): a savings product that serves as an alternative to traditional health insurance. HSAs enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.
  • Managed Care: a method of providing health care, in which the insurer and/or employer (policyholder) maintain some level of control over costs and utilization by various means. Typically refers to HMOs and PPOs.
  • Member: a term used to describe a person who is enrolled in an insurance plan; the term is used most frequently in managed care.
  • Open Enrollment: a set time of year when you can enroll in health insurance or change from one plan to another without benefit of a qualifying evening.
  • Out-of-pocket: money the patient's pays toward the cost of health care services.
  • Payer: the party who actually makes payment for services under the insurance coverage policy. In the majority of cases, the payer is the same as the insurer. But, as in the case of very large self-insured employers, the payer is a separate entity under contract to handle the administration of the insurance policy.
  • Policyholder: purchaser of an insurance policy; in group health insurance, this is usually the employer who purchases policy coverage for its employees.
  • Preferred Provider Organization (PPO): a form of managed care in which the member has more flexibility in choosing physicians and other providers. The member can see both participating and non-participating providers. There is a greater out-of-pocket expense if member sees non-participating providers.
  • Premium: the cost of an insurance plan shared by employer and employee.
  • Provider: one who delivers health care services within the scope of a professional license.
  • Reimbursement: refers to the payment by the patient (first-party) or insurer (third-party), to the health care provider, for services rendered.

Reference: www.apta.org

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