CareMount Medical participates in only the following individual plans listed on the New York State Individual Insurance Exchange:
CareMount Medical participates in only the following small business health plans listed on the New York State “SHOP” Exchange:
The following is a list of the Insurance Group Plans in which the CareMount Medical and ALL of its Physicians participate. Please verify your eligibility and coverage. If you have insurance coverage from a company other than listed below, services are probably “out of network” and you will be responsible for a greater out of pocket expense.
*†AETNA: HMO, POS, PPO, EPO Aexcel, Aetna Signature Administrator, Elect Choice, Managed Choice, Open Access, Open Choice, Premier Care Network (APCN), Performance Network (APN), Local 1199, Medicare HMO and PPO. Effective January 1, 2022 excludes Medicare individual plans. CareMount will remain participating in Medicare group plans provided by an employer or union.
**AFFINITY by MOLINA HEALTHCARE: Medicaid, Child Health Plus, Essential Plans (Excludes Harp Molina Healthcare Plus)
*CDPHP: Commercial Plans (Excludes Medicare plans, Essential Plans, Child Health Plus, Family Health Plus & Medicaid)
CIGNA: HMO, POS, PPO and EPO
CONNECTICARE: (Through Emblem Health Prime Network)
CONSUMER HEALTH NETWORK (CHN)
COVENTRY: PPO (Through First Health)
EMBLEMHEALTH Insurance Company (formerly HIPIC): Bridge Network (Excludes Select Care)
EMBLEM HEALTH PLAN, Inc (formerly GHI): CBP (PPO), HMO, Emblem Health (EPO & PPO), NYC Medicare Advantage Plus PPO effective April 1, 2022, Bridge Network & Medicare PPO: (Excludes Family Health Plus, Child Health Plus, Medicaid Managed Care, Medicare HMO and Medicare Plus Choice, Select Care)
EMPIRE BLUE CROSS/BLUE SHIELD: HMO, PPO, EPO, Health Plus, Health Plus Gatekeeper, Mediblue HMO and PPO (Excludes Pathway, Blue Priority Networks and Empire Blue Access Networks), NYC Medicare Advantage Plus PPO effective April 1, 2022
†FIDELIS: Medicaid, Essential Plans, Gold, Platinum, Bronze, Silver, and Medicare. Effective January 1, 2022 excludes Medicare plans
FIRST HEALTH: PPO, Coventry PPO
GREAT WEST HEALTHCARE: HMO & PPO
HIP: Emblem Health Prime Network (EPO & HMO), Bridge Network, Child Health Plus, Connecticare, Vytra Plans (Excludes Medicare and Medicare Essential, Medicaid CHP, HIP Classic, Comprehealth, Family Health Plus, Medicaid, Select Care, Millennium, and Enhanced Prime Networks)
HUMANA: Medicare Network PFFS, Medicare HMO & PPO
MAGNACARE: Including Brighton Health Plan Solutions
†MEDICARE: Traditional (Includes Railroad Retirees), Aetna HMO and PPO, BCBS Mediblue HMO and PPO, GHI PPO, HIP, Humana, MVP, Partners Health Plan, UHC Medicare Complete PPO, AARP HMO and PPO, UHC Community Plan Dual Complete Medicare, NYC Medicare Advantage Plus PPO effective April 1, 2022. Effective January 1, 2022 CareMount Medical will no longer participate in Fidelis Medicare and Aetna Individual Medicare plans. CareMount will remain participating in Aetna Medicare group plans provided by an employer or union.
MULTIPLAN: PPO Only
*MVP: Commercial, Medicare and Medicaid (Excludes Essential Plan & Premier Individual)
Northwell Direct Network
NYSHIP (Empire Plan)
OXFORD: Freedom and Liberty (Excludes Medicare Plans and Metro Network)
PARTNERS HEALTH PLAN: Commercial and Medicare
PHCS: PPO Only
UNITED HEALTHCARE: EPO, HMO, POS, HMO PLUS, PPO, Choice Plus, Select Plus, Medicare Complete PPO, AARP HMO and PPO, Community Plan Dual Complete Medicare (Excludes Community, Compass, Essential, Medicaid and Mosaic Plans)
*Local 1199, CDPHP and MVP plans are currently non participating in the Manhattan region
**Affinity by Molina plans are currently participating with select providers in the Manhattan region
†Effective January 1, 2022 CareMount Medical will no longer participate in Fidelis Medicare and Aetna Individual Medicare plans. CareMount will remain participating in Aetna Medicare group plans provided by an employer or union.
CareMount Medical accepts most major health insurance plans.
Before selecting a CareMount provider, please check with your insurance company to verify your eligibility and coverage to ensure the provider participates in your plan.
If you have insurance coverage from a company other than one listed, services are probably “out of network” and you will be responsible for a greater out of pocket expense.
If you are an uninsured or a self-pay patient, you have the right to request a good faith estimate of expected charges prior to receiving services.
For help selecting a plan that CareMount participates with please contact our Patient Assistance Department