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Patient Resources

Accepted Insurance Plans 2021

NY State Exchange Plans

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:

Insurance Plans

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, PPO, Aexcel, Premier Care Network (APCN), Performance Network (APN), Medicare HMO and PPO, Local 1199

**AFFINITY: Medicaid, Essential Plans (Excludes Enriched Health Harp)

*†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)

EMBLEM HEALTH PRIME NETWORK: EPO, HMO, PPO, POS and GHI PPO Medicare (Excludes Select Network and Enhanced Prime Network)

EMPIRE BLUE CROSS/BLUE SHIELD: HMO, PPO, Health Plus, Health Plus Gatekeeper, Mediblue HMO and  PPO (Excludes Pathway, Blue Priority Networks and Blue Access Networks)

FIDELIS: Medicaid, Essential Plans, Gold, Platinum, Bronze, Silver, and Medicare

FIRST HEALTH: PPO, Coventry PPO

GHI: CBP (PPO), HMO, Emblem Health (EPO & PPO) & Medicare PPO: (Excludes Family Health Plus, Child Health Plus, Medicaid Managed Care, Medicare HMO and Medicare Plus Choice, Select Care)

GREAT WEST HEALTHCARE: HMO & PPO

†HIP: Emblem Health Prime Network (EPO & HMO), Bridge Network, Medicare VIP Plan, Child Health Plus, Connecticare, Vytra Plans (Excludes Medicare* and Medicare Essential plans, 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 effective March 1, 2021.

MULTIPLAN: PPO Only

†MVP: Commercial, Medicare and Medicaid (Excludes Essential Plan)

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 effective March 1, 2021. (Excludes Community, Essential, Medicaid and Mosaic Plans)

*Local 1199, CDPHP and MVP plans are currently non participating in the Manhattan region
**Affinity plans are currently participating with select providers in the Manhattan region
†CareMount Medical will not be participating in CDPHP Medicare and HIP Medicare after January 1, 2021

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.

For help selecting a plan that CareMount participates with please contact our Patient Assistance Department
at 1-888-859-9473