Insurance Information

CareMount Medical participates in only the following individual plans listed on the New York State Individual Insurance Exchange:

• Affinity QHP and Essential
• CDPHP
• Fidelis
• CareConnect (North Shore-LIJ)

CareMount Medical participates in only the following small business health plans listed on the New York State “SHOP” Exchange:

• CDPHP
• MVP
• CareConnect (North Shore-LIJ)

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. Please call (914) 242-1388 to clarify before using services at CareMount Medical or if you would like to receive an estimate for your out of pocket costs.

• AETNA: Includes Medicare HMO, PPO, Aexcel Plans, Premier Care Network (APCN), Performance Network (APN)
• AFFINITY: Medicaid, Medicare and QHP, Essential Plans
• CARECONNECT: (North Shore -LIJ)
• CDPHP: (excludes Child Health Plus, Family Health Plus and Medicaid)
• CIGNA: HMO, POS and PPO products (Includes EPO & PPA)
• CONNECTICARE: (Through Emblem Health Network)
  CONSUMER HEALTH NETWORK (CHN)
  ELDER PLAN (Medicare Plan)
  
• EMPIRE BLUE CROSS/BLUE SHIELD: HMO, PPO, Mediblue HMO & PPO Only, Health Plus (formally known as Amerigroup), (Excludes Medicaid, Pathway and Blue Priority Networks)
• FIDELIS: Includes Medicaid and Medicare
FIRST HEALTH / CCN (also know as Coventry) PPO Only
• GHI: CBP (PPO), HMO & Emblem Health (EPO & PPO) & Medicare PPO: Excludes Family Health Plus, Child Health Plus, Medicaid Managed Care, Medicare HMO & Medicare Plus Choice, Select Care)
• GREAT WEST HEALTHCARE: HMO & PPO
• HIP & EMBLEM HEALTH PRIME NETWORK (EPO & HMO): Includes Medicare VIP Plan, Child Health Plus, Connecticare, Vytra Plans. (Excludes Medicaid CHP, HIP Classic, Comprehealth, Medicare Essential, Family Health Plus, Medicaid and Select Care)
• MAGNACARE: Excludes Oscar Health Insurance
• MEDICARE:Traditional (Includes Railroad Retirees), Aetna HMO and PPO Only, Affinity, BCBS Mediblue HMO & PPO Only, CDPHP, Elderplan, Fidelis, GHI PPO, HIP (Westchester residents only), MVP, Today's Options Medicare Advantage (American Progressive), PPO and PFFS plans, VNS, Wellcare (Exclusively for existing patients within plan), Excludes ALL other Medicare Advantage Plans
• MULTIPLAN: PPO Only
• MVP: Includess Medicare and the former Hudson Health Plan and exclusively for existing patients already within the plan Effective 1/1/15. Medicare 1/1/15. (Excludes Essential Plan, Family Health Plus & Child Health Plus)
  NHA (National Health Administrators)
  NYSHIP (The EMPIRE PLAN)
  
• OXFORD: Freedom and Liberty. (Excludes Medicare Plans and Metro Network Plans effective 1/1/2017)
  PARTNERS HEALTH PLAN
  PHCS (Includes Today's Option) PPO Only
  POMCO
  
• TODAY'S OPTIONS PPO MEDICARE ADVANTAGE (American Progressive): PPO and PFFS Plans
• UNITED HEALTHCARE: EPO/NPP, HMO, POS, HMO PLUS, PPO (Excludes Medicare Advantage and Medicaid)
  VNS (Visiting Nurse Services) (Medicare Plan)
  
• WELLCARE: Includes Medicare & Medicaid (Exclusively for existing patients already within plan) Effective 1/1/15 (Excludes HMO)