Insurance Information

We are currently a participating provider for the following insurance companies:

• 1199 National Benefit Fund
• ACPN
• Aetna
  • All Plans except Better Health
• Affinity Health Plan (NY offices only)
• Amerigroup (MD offices only)
• Amerigroup New Jersey (NJ offices only)
• Amerigroup/Health Plus (NY offices only)
• Amerihealth (PA offices only)
• Amerihealth Caritas DC (MD offices only)
• Amerihealth of New Jersey (NJ offices only)
• Amida Care (NY offices only)
• Anthem (VA offices only)
  • HealthKeepers, HMO, PPO
• Blue Cross/Blue Shield
  • AK: Premera – All Plans
  • CT: Anthem – All Plans
  • MA: All Plans
  • MD: Carefirst – All Plans. For all other BCBS plans, only Federal Plan and Blue Card PPO are accepted.
  • NC: all plans except UNC Health Alliance
  • 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.
  • TX: All Plans
  • VA: Anthem Health Keepers
  • VA: Anthem PPO
  • VA: Carefirst
• CDPHP – Capital District Physicians' Health Plan (NY Offices only)
• Cigna
  • All Plans
• Connecticare Health Plan (CT offices only)
• Denali-Mcaid (AK offices only)
• Emblem Health
• Emblem/GHI
• Emblem/HIP
  • all plans
• Empire Plan
• Fidelis (in-office care only)
• Harvard Pilgrim (MA and CT offices only)
• HealthFirst (NY offices only)
• Healthlink
• Horizon NJ Health (NJ offices only)
• Humana
• Husky Health Plan (CT offices only)
• Island Group Administrators (NY offices only)
• Johns Hopkins Healthcare (MD offices only)
• MagnaCare
• Maryland Physician Care (MD offices only)
• MassHealth (MA offices only)
• MedStar Family Choice (MD offices only)
• MetroPlus
• Molina Healthcare (TX offices only)
• Multiplan
• MVP – All Plans
• Neighborhood Health
  • – All Plans
• Neighborhood Health Plan (MA offices only)
• No Fault
• Optima Health (VA offices only)
• Oxford
• Parkland Community Health Plan (TX offices only)
• PHCS
• POMCO
• Priority Partners (MD offices only)
• Qualcare (NJ offices only)
  • all plans except Atlantic Health System
• Three Rivers
• Tricare
• Tufts Health Plan (MA offices only)
• United Healthcare
  • All Plans
  • Commercial Plan Only
• University of Maryland Health Partners – formerly Riverside Health (MD offices only)
• US Family Health Plan (MD offices only)
• USA MCO
• VA Premier
  • All Plans
• 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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