INSURANCE |
PATIENT |
REFERRAL INFO |
CoPay/Deductible |
AETNA
US Healthcare |
See any DR |
PPO - no referral
HMO- referral
required |
Check address on card |
Anthem Benefit Administrators |
SS |
|
OH |
BLUE SHIELD
( see following list) |
See any DR or PA
|
|
|
City of Erie
County of Erie
Keystone/ Blue Chip |
See any DR or PA |
|
- No copay
- No copay
- No copay
|
Community Blue Direct
FEP
Keystone / Blue Chip
Preferred Blue
Premier
Select Blue
Security Blue |
See any DR or PA |
- Referral required |
Check card for copay |
Adult Basic (audio services
not covered) |
See any DR or PA |
Referral required |
No copay |
Special Care |
See any DR or PA |
|
Allowed only 4 visits per/yr. w/any type of DR |
Comprehensive |
See any DR or PA |
No referral-Major medical/BS combined |
Check card for copay/deduct |
Major Medical |
See any DR or PA |
No referral |
Pt. pays off/visit submits own claim for reimbursement |
Out of state Blue Shields |
See any DR or PA |
|
We submit to PA BS for reimbursement |
Bureau of Disability Determination |
See only SL, JA, SC, RF |
Disability Paperwork required. |
Appointment made by Bureau of Disability
Paperwork required (we cannot reschedule) Pt. must contact disability if unable to keep appointment. |
Devon Health Services |
See any DR |
|
King of Prussia |
Direct Care America
(The Chandler Group) |
See any DR |
|
Stow , OH |
Emerald |
SS |
|
Ohio |
First Health Plan
(was Affordable) |
See any DR or PA |
No referral required |
|
Foster Children
(any ward of state) |
See any DR |
No referral required |
|
GEM |
SS |
|
Ohio |
Great West Health Care
One Health Plan, Inc |
See any DR |
No referral required |
|
Health America/Health Assurance |
See any DR |
|
|
HealthNow New York, Inc. |
See any DR |
|
|
Independent Health |
See any DR or PA |
Referral required |
|
InterGroup Services Corp.
( Beech Street ) |
See any DR or PA |
PPO - no referral required |
|
Medical Assistance
(see plans below) |
|
|
|
Access (Medial Assistance)
Adult - over 21
Child - under 21 |
Adult - See PA First
Child - See PA first |
Adult - No referral required
Child - Referral from PCP required; good for 6 mos. |
|
Gateway Health Plan |
See any DR |
Referral from PCP required
(referral good for 60 days) |
|
Unison
(formerly Med Plus) |
See any DR or PA |
Referral required from PCP (good for 60 days) |
|
New York State Dept. of
Health (NY MA) |
See any DR or PA |
No referral required |
|
Ohio MA |
See SS or PA |
|
|
Three Rivers Health Plans
MedPLUS |
See PA first |
Referral required from PCP (referral good for 60 days) |
|
Sierra Military Health Services
Tricare |
|
|
|
Tricare (Champus) |
See any DR or PA |
No referral |
|
Tricare - HMO Prime |
See any DR or PA |
Referral required |
|
St. Paul's Neighborhood Free Clinic |
See only Residents |
No referral required - must be scheduled by clinic |
|
UPMC |
See any DR or PA |
Verbal authorization required from PCP prior to scheduling appointment |
**Best Healthcare /UPMC for ME- we DO NOT participate !
|
United Healthcare |
See any DR or PA |
No referral |
Our doctors are nonparticipating. Patient pays office visit and submits own claim for reimbursement. |
Univera Healthcare
Excellus Health Plan
Senior Choice -Medicare
|
See any DR
-- SS , SC , RF (Senior) |
(previously Univera Healthcare-Southern Tier, Univera Healthcare, Univera, North AmeriCare ) |
|
Vantage Healthcare Network |
SL, SS, JA, KS |
No referral |
PPO |
