Our Participating Plans

Understanding your insurance:

INSURANCE PLAN NAME VS. NETWORK...  Please have your insurance cards available when you call to make your appointment.  It has become more complicated than it used to be to determine if we participate in your plan.  Even if we have a contract with a payor, there could be some exceptions, depending on the network being utilized.  We may need to ask you for some information from your card.  We will help as much as possible to figure this out, but the best way to verify that we are in network is to check directly with your plan.

Hint:   If you are shopping on healthcare.gov, after you select a plan on the Marketplace, you will have the option to click on the Provider Directory to search for us as a provider.  Just click on 'quick link' to get the the provider search.

REFERRALS:  If your plan requires that you get a referral, be sure to click on the Referral tab under Insurance for instructions.

Please scroll down to find information about...

  • A list of plans that we accept
  • Affordable Health Care/MarketPlace plans available for our area in 2017
  • A special note concerning United HealthCare Medicare Plans
  • Medicare and Medicare Supplement information

We do accept these plans:

Move the cursor over insurance if underlined for more information on that plan.

  • Aetna HMO/PPO
  • Anthem: includes Blue Access, Blue Access Choice, Blue Preferred, Traditional
  • Baxter Regional Health Plan PPO
  • Beech Street PPO
  • Best Doctors Inc
  • Cigna GWH Plans
  • Cigna: includes HMO/POS/PPO/Open Access
  • Cigna Connect: includes Bronze, Silver and Gold. 
  • Cigna Connect Flex:  Includes Bronze, Silver and Gold
  • Coventry HMO, PPO & POS
  • Coventry CMR
  • Coventry Advantra HMO and PPO (Medicare) 
  • Coventry Gold Advantage (Medicare) 
  • First Health Coventry National
  • Healthlink HMO/POS
  • Healthlink PPO
  • HFN Inc.
  • Humana Choice Care
  • Medicare (traditional) and Rail Road Medicare
  • Medicare Complete by United HealthCare  (maybe)
  • MultiPlan
  • PHCS (Private Healthcare Systems)
  • Union Pacific Railroad
  • United HealthCare commercial plans (includes Choice & Choice Plus; Compass, Charter, Core & Navigate)
  • USA Managed Care Organization

 


Plans available on the Marketplace in 2017:  
This is a list of plans offered through the MarketPlace for 2017, and our participation status in those plans.  

Anthem BCBS offers the following plans on and off the Marketplace.  We do not participate in any version of these Anthem plans.  

  •  Bronze Pathway X PPO
  • Silver Pathway X PPO
  • Silver DirectAccess (a Multi-State Plan) PPO
  • Gold DirectAccess (a Multi-State Plan) PPO 

Cigna offers the following plans on and off the Marketplace.  We are in network for all of the Cigna plans.  Patients are encouraged to select a PCP and obtain a referral to see a specialist with these plans. We will see patients without a referral, but it will result in higher out-of-pocket costs for the patient. 

  • Cigna Connect Bronze EPO
  • Cigna Connect  Silver EPO

A special note about United Healthcare Medicare plans:

We are not contracted with United Healthcare for the Medicare Plans. 

UnitedHealthcare Group medicare Advantage PPO:  No contract is required, so if you have this plan, you can see any doctor who participates with traditional Medicare.  Hint: These cards will have H1537 or H2001, and the employer name printed on the card.

UHC Medicare PPO:  The PPO plans provide Out-of-Network benefits.  You will have a 30% coinsurance if seen in our office. These plans have H2228-030 or H2228-048 on the cards for 2017.

UHC Medicare HMO:   Since we do not have a contract for this plan, you will not have any benefits if seen in our office.

Please note, the information provided here is as we understand it. You should always verify your benefits with your plan before making appointments.


About Medicare and Medicare Supplement Plans:
If you have traditional Medicare as primary insurance, and your secondary insurance card has "Medicare Supplement" written on it, then you have a  Medicare Supplement plan.   It is designed to work with Medicare .  If Medicare approves your charges, then the supplement plan will also cover your charges. Deductibles may still apply.


 

Copyright © 2017 Laura Wagner, MD. All Rights Reserved.
14377 Woodlake Dr. #111 • Chesterfield, MO 63017
314-434-1111