Insurances We Accept

Current List of Plans We Accept (as of December 19th, 2024):

Aetna:

• HMO, PPO/EPO, POS

• 1199 National Benefit Fund

• We are not in Network with Aetna Whole Health.

Anthem Blue Cross Blue Shield:

• (Out-of-state plans must be part of the blue care network)

• We do not see out-of-state patients with any Pathway Plans.

• We do not participate in any Medicaid plans through Blue Cross Blue Shield

Cigna:

• HMO, PPO/EPO, POS

• Medicare

ConnectiCare:

• (Note: We are not in network with the Value Plans)

• We are no longer accepting new or existing patients with HMO plans that require a referral

Empire New York State Government Plan/NYSHIP:

• Excludes Medicaid

First Health/Coventry:

• Excludes No Fault, Workers’ Compensation, and Medicare

Harvard Pilgrim Health:

• All plans accepted

Magna Care:

• All plans accepted

Medicare:

• Traditional Medicare & Railroad Retiree

• Anthem Blue Medicare Advantage PPO CT (No Medicaid)

• ConnectiCare VIP Medicare Advantage Plans (No Medicaid)

• Cigna Medicare

• (Note: We are not in network with any other Medicare Advantage Plans which include but are not limited to Humana Medicare, WellCare Medicare, etc.)

Multiplan:

• We do not accept Medicaid plans

Oxford:

• Liberty and Freedom Plans only (Referrals may be required; please obtain them prior to making an appointment)

United Healthcare: Commercial plans only

Nonparticipating plans:

·         Medicaid/Husky (Our doctors cannot prescribe medication or order testing. If you have Medicaid or Husky as a primary, secondary, or third plan, you will need to seek a provider that accepts both.)

Emblem Health: We are not currently accepting any new patients:

·         We no longer accept new patients in the GHI City of New York Plan. You may have out-of-network benefits, but you will need to pay us in full & submit your own claims to the insurance company for reimbursement, as we will not submit them on your behalf. Emblem Health NY Plans (Dr. Sproviero no longer accepts new patients on these plans. Our other physicians are not participating)

• We are no longer accepting new or existing patients with HMO plans that require a referral.

• We are not accepting new or existing patients on HIP plans

·         Oxford plans that are: Metro, Community, Charter, Medicaid

·         ConnectiCare of Massachusetts

·         United Healthcare plans: Community, Compass, Metro, Charter Core, and Navigate, Medicaid (This includes United Healthcare Medicare Dual Complete)

·         Tricare (If you have out-of-network benefits, we will submit on your behalf)

Please ensure you verify with your insurance provider to confirm network participation. If FCAAIA is not a participating provider for your plan, they can provide an estimate for services rendered. For additional questions or estimates, please contact the Billing Office at 203-838-4034 Ext 136.