Insurance Information
We are currently a participating provider for the following insurance companies:
- 1199 National Benefit Fund
- ACPN
- Aetna
- All Plans except Better Health
- Aetna Better Health
- Aetna Telemed
- Affinity Health Plan (NY offices only)
- Allways – formerly Neighborhood Health (MA offices only)
- Ambetter (NC offices only)
- Amerigroup (MD, NJ and TX offices only)
- Amerigroup New Jersey (NJ offices only)
- Amerigroup/Health Plus (NY offices only)
- Amerihealth (PA offices only)
- Amerihealth Caritas
- Amerihealth Caritas DC (MD offices only)
- Amerihealth of New Jersey (NJ offices only)
- Amida Care (NY offices only)
- Only at Hopewell Junction, Spring Valley, Yonkers and Mamaroneck locations.
- Anthem (VA offices only)
- Anthem BCBS
- AvMed
- BCBS Highmark
- BCBS Mass
- Blue Cross/Blue Shield
- NJ: Horizon – All Plans; all other BCBS, Federal Plan, and BLUE CARD PPO only
- NY: Empire – All Plans. For all other BCBS plans, only Federal Plan and Blue card PPO are accepted.
- PPO, HMO and Indemnity plans
- TX: All Plans
- VA: Anthem Health Keepers
- VA: Anthem PPO
- VA: Carefirst
- Blue Shield of California
- Blue Shield of California Exchange
- Capital District Physician Health Plan
- CDPHP – Capital District Physicians' Health Plan (NY Offices only)
- Cedar Sinai Medical
- Cigna
- All offices except TN & FL
- All Plans
- Connecticare Health Plan (CT offices only)
- Contigo Health
- Coventry
- Denali-Mcaid (AK offices only)
- Eastland
- Emblem Health
- Emblem/GHI
- Emblem/HIP
- Empire Plan
- Fallon
- Fallon Medicaid
- Fidelis Care
- Harvard Pilgrim (MA and CT offices only)
- HealthFirst (NY offices only)
- Healthlink
- Healthnet
- Hooray Health
- Horizon NJ Health (NJ offices only)
- Humana
- Husky Health Plan (CT offices only)
- Illinicare (IL offices only)
- Island Group Administrators (NY offices only)
- Johns Hopkins Healthcare (MD offices only)
- Keystone First (PA offices only)
- Lakeside Medical
- MagnaCare
- Maryland Physician Care (MD offices only)
- MassHealth (MA offices only)
- MedStar Family Choice (MD offices only)
- Meridian Health (IL offices only)
- MetroPlus
- Molina (TX, CA, IL offices only)
- Molina Healthcare (TX, CA, IL offices only)
- Multiplan
- MVP – All Plans
- No Fault
- North Carolina Medicaid (NC offices only)
- Optima Health (VA offices only)
- Oscar
- Oxford
- Parkland Community Health Plan (TX offices only)
- PHCS
- Point Comfort Underwriters
- POMCO
- Priority Partners (MD offices only)
- Qualcare (NJ offices only)
- all plans except Atlantic Health System
- Regal Medical
- Scott & White
- Seton Health Plan
- Three Rivers
- Tricare
- Tufts Health Plan (MA offices only)
- UHC
- UHC Harvard Pilgrim
- United Healthcare
- United Healthcare Community Plan
- Community Plan in network in New York until 12/31/2021. Other participating states will remain in network.
- University of Maryland Health Partners – formerly Riverside Health (MD offices only)
- US Family Health Plan (MD offices only)
- USA MCO
- VA Premier
- Virginia Premier (VA offices only)
- Vytra Healthcare
- WellCare (NJ offices only)
Many of our accepted insurance carriers feature “network access plans,” with whom we also participate. If you don’t see your plan listed here, please call your nearest PM Pediatrics office or contact us to find out more information. Our billing department can be reached during normal business hours at (516) 869-0650 x305.
Other Insurance Plans
PM Pediatrics is currently in discussions with many other plans and we anticipate becoming a participating provider with a number of them in the coming months.
Out-of-Network Options
For those plans for which we are Out-of-Network, we offer:
- Simple, reasonable fees with no surprises; only three fee levels, depending upon the complexity of the visit.
- Flexible payment options.
- Assistance with submitting claims.
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