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Patient Resources

Accepted Insurance Plans 2020 – 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

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

CDPHP: Commercial and Medicare* (Excludes Essential Plans, Child Health Plus, Family Health Plus & Medicaid) *CareMount Medical will not be participating in CDPHP Medicare after January 1, 2021

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 Medicaid CHP, HIP Classic, Comprehealth, Medicare Essential, Family Health Plus, Medicaid, Select Care, Millennium, and Enhanced Prime Networks) *CareMount Medical will not be participating in HIP Medicare after January 1, 2021

MAGNACARE: Including Brighton Health Plan Solutions

MEDICARE: Traditional (Includes Railroad Retirees), Aetna HMO and PPO, BCBS Mediblue HMO and PPO, Fidelis, CDPHP* GHI PPO and HIP*, MVP, Partners Health Plan.  *CareMount Medical will not be participating in CDPHP and HIP Medicare after January 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 Advantage (Excludes Community, Essential, Medicaid and Mosaic Plans)