Overview
健康保险计划的不断变化使得了解你的保险范围变得极其重要, 包括你在看医生或做检查和手术时必须支付的费用. For this reason, 米德尔敦医疗建议你在下次预约前了解你的计划的细节. For example, 你的健康保险计划可能需要多次共同支付, higher deductibles, and coinsurance. 保险范围将取决于你选择的保险类型.
We accept most major insurance plans. 如果您没有看到下面列出的保险计划，请致电我们的办公室获取最新信息. 参与供应商如有更改，恕不另行通知.
Effective April 5, 2016, 我们将不再接受Crystal Run健康计划的服务，但我们仍将接受Magnacare
Effective January 1, 2024, we are Non-Par with United Medicare HMO or POS plans.
Patients who are part of retiree groups, 他们的名片背面印着“退休人员”的字样, we remain in the network with.
在PPO计划下的患者可以在网络外的基础上继续来MMPC.
Effective April 15, 2024, we Non-Par with Cigna.
在PPO或开放获取计划下的CIGNA患者可以在网络外的基础上继续来到MMPC.
Insurances We Accept
A-F
AARP医疗保险(仅当卡上写着退休人员)
American Progressive
Aetna (PPO)
Aetna (HMO)
Aetna Medicare
Anthem
Beech Street
BCBS EPO
BCBS HMO
BCBS Mediblue Par 6/1/2024
BCBS Medicaid- prefix JLJ We will accept this insurance effective 6/1/24
BCBS - prefix VFG, VJD We will accept this insurance effective 6/1/24
BS of Northeastern Healthnow
CDPHP
Connecticare
EmblemHealth HIP Medicare (We Only accept NYC Retirees Empire BC/BS PPO/EPO)
Fidelis Essential Plan - Requires PCP assignment Fidelis Medicare
Fidelis Medicaid
Fidelis HMO
First Health (By Aetna)
G-M
GHI
GHI HMO
GHI HMO Medicare Plan
HealthFirst
HealthPlus MA DSNP - Y8E We will accept this insurance effective 6/1/24
HealthPlus MA HMO - Y7N We will accept this insurance effective 6/1/24
HIP HMO
Local 338 Health Plan
Local 812/Vista/Crossroad
Local 825
Local 1199 SEIU Benefit Fund
Magnacare(晶润健康计划产品除外)
NY Medicaid on a case by case basis
Medicare
Medichoice
Mediblue HMO Senior Plan
Molina
Multiplan
MVP
O-Z
Oxford
Oxford PHS/Healthnet
Pomco
Railroad Medicare
Secure Horizon Oxford
Seiba
Tricare HMO -需要转介去看专家和测试
Tricare – Active Military
United Healthcare Empire
United Healthcare (HMO)
United Healthcare (PPO)
US Family Health Plan – Tricare Prime Program PPO
We now accept payments from CareCredit®. What is CareCredit®?
CareCredit® is a health, wellness, 个人护理信用卡，帮助病人和客户得到他们想要和需要的护理, without delaying appointments or treatment.
持卡人可以使用CareCredit的促销融资来支付免赔额, copays, and treatment not covered by insurance,* while you get paid in two business days.
Visit www.carecredit.com for more information.
More Info
了解您个人医疗保健政策的细节, you can visit your insurance company’s website, 查看您的会员手册或联系您公司的客户服务部门. 你的保险卡背面应该包括电话号码和网站信息.
Some key information you need before your visit:
- Is my doctor’s visit covered completely? 如果没有，我是否有一个共同支付或扣除金额来满足?
- 如果我需要任何检查，它们会被完全覆盖吗? If not, how much will I be expected to pay?
- 如果我需要一个程序，包括手术，我的保险将支付多少? How much will I be expected to pay?
- 在去看医生之前，我需要得到授权吗?
Billing FAQs
What is a deductible?
免赔额是你在保险计划开始报销之前支付的“承保”健康费用的初始金额. A deductible is usually a set dollar amount, such as $250 or $500, 但根据您选择的政策，可能会更高.
If your insurance pays all but a deductible, 您需要在服务时支付账单中您那部分的估计金额.
What is co-insurance
Co-insurance is your share of the costs of a healthcare service. 它通常以服务总收费的百分比计算. 你在支付了计划的免赔额后开始支付共同保险.
For example, if you’ve paid your $1,500 deductible for the year, and your plan covers 70% of a particular cost, 然后你负责支付另外的30%这是共同保险.
了解你的保险包括什么，不包括什么，对你最有利, of example co-pays, deductible and co-insurance, what you are responsible for, 以及我们在bbin为您提供服务时对您的要求
米德尔顿医疗接受什么类型的保险?
What is a co-payment?
共同支付(co-pay)是你的医疗费用中不包括在保险范围内的部分. 这是你的保险公司规定的你对你所提供的每项服务负责的金额, and is required to be paid at the time of treatment.
您的共同支付信息可能在您的保险卡上列出如下:PCP, Specialist, Urgent Care, ER. 每种类型的服务也可能有单独的自付费用.
例子:办公室拜访，化验(血液检查)，诊断测试(x光).
Who is responsible for paying my bill?
在服务期间，您负责您的共同支付、共同保险和/或免赔额.
Middletown Medical will bill your insurance company directly on your behalf (unless you specify otherwise); however, 你最终有责任确保你的账单被支付.
如果在你的保险公司发出拒绝付款后仍有余额, you will receive a bill asking for payment, 在收到你的账单后立即支付. 我们接受现金、支票、汇票和信用卡.
In certain circumstances, 你可以按月向米德尔敦医疗公司付款，直到你的账单全部付清. 您应该通过致电bbin-bbin-5199(工作日上午8:30开放)与我们的计费部门讨论此问题.m. to 4 p.m.).
HELPFUL DEFINITIONS:
Beneficiary: 保险受益人:从任何保险计划或政策中获得利益的人.
Claim: 为提供商提交的服务付款的请求.
Co-insurance: 保险公司要求受益人为符合条件的医疗费用支付一定比例的承保费用.
Co-pay or Co-payment: 在提供任何服务之前，保险公司与受益人之间签订的一笔特定的固定金额.
Covered Services: Services for which an insurance policy will pay.
Deductible: 受益人在保险单给付之前必须支付的一定金额的医疗费用.
Explanation of Benefits (EOB): 保险公司对索赔处理过程的说明.
Medically Necessary: 合同中规定的由保险单支付的治疗或服务.
Non-Covered Services: 保险单不提供赔偿的服务. 这些服务将在服务时由患者支付.
Pre-Certification/Authorization: 在提供医疗服务之前必须获得保险公司批准的特定服务要求.
Provider: 医务人员:提供医疗服务的个人或组织.