Patient Resources

Accepted Insurance Plans 2019

NY State Exchange Plans

CareMount Medical participates in only the following individual plans listed on the New York State Individual Insurance Exchange:

  • Affinity Essential
  • CDPHP
  • Fidelis

CareMount Medical participates in only the following small business health plans listed on the New York State “SHOP” Exchange:

  • CDPHP
  • MVP

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

AFFINITY: Medicaid, Essential Plans

CDPHP: Commercial and Medicare (Excludes 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 Medicare (Through GHI or HIP) (Excludes Select Network and Enhanced Prime Network)

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

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

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), Medicare VIP Plan, Child Health Plus, Connecticare, Vytra Plans (Excludes Medicaid CHP, HIP Classic, Comprehealth, Medicare Essential, Family Health Plus, Medicaid, Select Care, and Enhanced Prime Networks)

MAGNACARE: Including Brighton Health Plan Solutions

MEDICARE: Traditional (Includes Railroad Retirees), Aetna HMO and PPO, BCBS Mediblue HMO and PPO, CDPHP, GHI PPO and HIP, MVP, Partners Health Plan, Wellcare and Wellcare Today’s Options

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 (Excludes Medicare Advantage, Medicaid and Community Plans)

WELLCARE: Medicare, Todays Option Medicare, Medicaid & Essential Plans