Our Participating Plans

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

UNDERSTANDING YOUR INSURANCE
INSURANCE PLAN NAME VS. NETWORK...  Please have your insurance cards available when you call to make your appointment.  Some plans require that we dig a little deeper to figure out if we participate in specific networks of your plan. We ask that you bear with us when we ask questions and that you provide the information we are asking for.  Remember, it is ultimately your responsibility to know that your providers participate with your plans. If there are any questions, you should 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,  you are responsible for requesting the referral from your primary care physician and for making sure that we receive the referral prior to your visit.  See the Referral tab under Insurance.

Please scroll down to find information about...

  • Affordable Health Care/MarketPlace plans available for our area in 2020.  
  • A list of plans Medicare plans that we accept.  
  • A list of Commercial plans that we accept.  

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2020 MARKETPLACE PLANS   
This is a list of plans offered through the MarketPlace for 2020, and our participation status in those plans.  

Cigna Connect is offered both on and off the marketplace.  We do participate in all of the Cigna Connect plans. 

Ambetter offers several optionsboth on and off the Marketplace.  We do not participate in any version of the AmBetter plans and they will not provide benefits in our office.

WellFirst offers several options both on and off the Marketplace.  We do not participate in any version of the WellFirst plans and they will not provide benefits in our office.  

MEDICARE HEALTH PLANS    black = accepted      red = not accepted      
Aetna Medicare Premier Advantra PPO
Aetna Medicare Value Advantra PPO
Aetna Medicare Advantra 1 HMO-POS
Aetna Medicare Advantra 2 HMO   referral required
Aetna Medicare Elite PPO
Aetna Medicare Premier Plus PPO
Aetna Medicare Gold Advantage Prime HMO    referral required
Aetna Medicare Gold Advantage Value Prime HMO    referral required
Aetna Medicare Assure Gold Prime HMO D-SNP      referral required
Aetna Medicare UnityPoint Health Prime HMO - NON PAR
Aetna Medicare Prime HMO-POS - NON PAR
Aetna Medicare PPO
Anthem Medicare Advantage (MA)
Humana Medicare HMO - NON PAR
Medicare (traditional)
RailRoad Medicare
United HealthCare Medicare Complete Choice  - non par but plan has out of network benefits
United HealthCare Group Medicare Advantage PPO - non par but plan has out of network benefits
United HealthCare Group Medicare Advantage HMO
 

COMMERCIAL HEALTH PLANS    black = accepted    red = not accepted    
Ambetter

Aetna
Aetna HMO
Anthem Blue Access and Blue Access Choice
Anthem Blue Preferred HMO      referral required
Anthem Blue Preferred PPO
Anthem FEP (Federal)
Anthem Pathway and Pathway X, Anthem Direct Access, Anthem Multi-State, Anthem Alliance
Baxter Regional Health
Beech Street
Best Doctors, Inc. PPO
Carpenters (processed by Meritain)
Cigna HealthCare of St., Louis HMO   referral required
Cigna Local Plus      check insurance card regarding referral
Cigna OA, OAP
Cigna Choice Fund: PPO,  OA Plus, OA Plus with CareLink
Cigna PPO  
CIgna SureFit, aka St. Louis SureFit
Cigna Connect Network
Coventry Commercial
Coventry National
Coventry CMR, self insured ASO, OPM administered
Coventry HMO, PPO, POS
Coventry Select and Carelink
District 9 (processed by Meritain)
Essence
Exclusive Choice

First Health 
Golden Rule
Healthlink HMO   requires referral
Healthlink PPO, POS, HMO-OA
HFN.Inc.
Humana Commercial Products - we participate in CHOICE CARE only
Humana Medicare Supplement
IBEW  (processed by Cigna)
Indiana Roofers  (processed by Healthlink)
Liberty HealthShare
Medicare or any Medicaid HMO or PPO product
Mercy Anthem Blue Access Choice
Mercy Anthem Alliance
Meritain
Multiplan
NALC  (processed by Cigna)
Painters  (processed by Healthlink)
PHCS Private Healthcare Systems
Plumbers & Pipefitters  (processed by Meritain)
Sheet Metals  (processed by Meritain)
Solidarity HealthShare
SSM & SSM CoreSource
Tricare for Life Medicare Supplement
Tricare, all other
UFCW  (processed by Meritain)
UMR
Union Pacific RailRoad
United HealthCare: Choice & Choice Plus, Allsavers, Core
United HealthCare Compass, Navigate, Charter   referral required
WellFirst
 

 



 

 

 

 

 

Copyright © 2020 Laura Wagner, MD. All Rights Reserved.
14377 Woodlake Dr. #111 • Chesterfield, MO 63017
314-434-1111