COMMERCIAL INSURANCE PLANS (updated 3/1/2011)

We have contracted with the following insurance plans and are "in-network" providers.  Please see the note below regarding other plans.

Aetna (All commercial Aetna plans)

BeechStreet

BlueChoice of SC(formerly Companion -this is NOT standard BCBS PPO)

Carolina Care Plan (now SuperMed)

CCN

Cigna (all Cigna NC, SC, and national plans)

FirstHealth

GE Health Care Preferred (Humana)

Golden Rule (plans that utilize the UHC provider network)

Great West (PPO and POS plans)

Humana

Kanawha

Mail Handler's

Medcost (All plans)

MultiPlan, Inc.

OneNet (by UnitedHealthCare)

ppoNEXT (now BeechStreet)

Premier Health PPO

Primary Physician Care

Private Healthcare Systems (PHCS)

Provider Select

SuperMed Network

Tricare (all Tricare plans - Prime, Standard, Tricare for Life, etc.)

United HealthCare (All commercial UHC plans)

USA Managed Care

Wellpath  and SouthCare PPO

 

MEDICARE INSURANCE PLANS

You will receive an in-network benefit level if you have one of the following Medicare or Medicare Advantage plans:

Medicare Part B (original Medicare with or without a supplement)

AARP

Aetna Medicare

BCBS SC MEDICARE (SC only - we are out of network with the NC BCBS Medicare plan)

Care Improvement Plus

Guardian Healthcare

Humana Medicare

MVP Health Care

Railroad Medicare

SecureHorizons

Sterling Health Plans

UnitedHealthcare Medicare

Universal Health Medicare

Windsor Health Plans

Notes regarding Medicare Advantage Plans: We will file your insurance claim for any Medicare Advantage plan, but you are responsible for knowing your coverage limitations if we are outside your Medicare Advantage network. Please call for status if you have questions or a plan that is not listed. 

Notes regarding original Medicare Part B Coverage: If you have original Medicare Part B and a secondary or supplementary insurance, we will file your claim with both of your insurance plans. There is a difference between supplement and secondary insurance. Medicare Supplement insurance is a policy that is purchased to pay either the Medicare deductible or Medicare co-insurance or both and often has a prescription drug benefit. Secondary insurance is typically a retirement benefit that sometimes, but often will not cover the Medicare deductible and/or coinsurance, but generally has a drug benefit. Again, it is up to the patient to understand his or her insurance and its coverage limitations.  The 2011 Medicare annual deductible is $162.00 and coinsurance remains at 20%.

If the health insurance plan that you have is not listed above, then it is possible that it is administered through a company such as Medcost, PHCS, or other listed third party administrator where we have an in-network contract.  Please call us if you are unsure.

Let us know if you have an insurance plan that you would like us to participate in as a preferred in-network provider.  With the exception of BCBS PPO plans (non-Medicare), we don't know of any commercial plans where we are not preferred providers. Please note that we are not contracted with any Workers Comp or Medicaid plans.

Currently, the only insurance plan in our market that will not negotiate in good faith:

BlueCross BlueShield PPO (BCBS Commercial PPO Plans)

For the time being, we have opted out of the BCBS PPO network.  If you have a BCBS plan other than BlueChoice (Companion) or BlueCross SC Medicare, please click here for more information.

BlueCross BlueShield of SC is a private company with over $2.5 billion in annual revenues and over $1 billion in reserves.  Yet they pay physicians far less than government healthcare plans for our military (Tricare) and our Medicare senior citizen recipients as well as all other commercial insurance plans in SC and surrounding states. Some might say that BCBS SC subscriber premiums pay for abnormally high corporate executive compensation and reserves instead of medical care.

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