Insurances We Accept

Scroll down to find some useful information about insurance and a list of plans we are in, including:

• MarketPlace (HealthCare.Gov) plans available in our area for 2025
• Medicare plans that we accept
• Commercial plans that we accept. 

Here's some things you need to know about your insurance coverage in our office.

• We are listed as a specialist with insurance plans.
• We have listed the plans that we participate in. The list of non-par plans does not represent every plan that we are not in, but only those more commonly seen in or area. If you don't see your plan on the list, you should check with insurance company to see if you have restrictions on where you can get care.

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.

IN-NETWORK versus OUT-OF-NETWORK participation status.   This is important!

• When a provider is contracted with an insurance, they are considered in-network, or a  participating provider. 
• When a provider is not contracted with an insurance, they are considered out-of-network, or a non-participating provider. This means you will have zero benefits or limited benefits for services provided. It is your responsibility to check with your insurance company for details and limitations for out-of-network services.

PLAN TYPES:   Know your plan. This is really important too!
It is your responsibility to verify your out-of-network benefits with your plan.  *

PPOs - Preferred Provider Organizations:   If we participate - ok.   If we do not participate - it's still ok.
The plan prefers that you use an in-network provider, but they will pay for out-of-network services. Be prepared to pay more for out-of network services. No referrals required. Please verify coverage with your insurance.

POS - Point of Service:  If we participate - ok.   If we do not participate - no benefits. 
You will need to get care from a provider within the network. You will need a referral from your primary care doctor to see a specialist within your network.  

HMOs - Health Maintenance Organizations:   If we participate - ok.  If we do not participate - no benefits.
You will probably be limited to using in-network providers if you expect to have any benefits. And you will probably need a referral to see a specialist.

EPOs - Exclusive Provider Organizations:  If we participate - ok.   If we do not participate - no benefits. 
They want you to exclusively use in-network providers.   

If a plan offers multiple plan types, we have listed the plan types of the insurance to help you determine if we are in-network, or participating.

We have also listed the plans in black and blue and red to show you at a quick glance about our participation status in each plan.  We have also noted each plan specically if Non-Par or Out-of-Network.
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MARKETPLACE PLANS (HealthCare.gov)    2025
This is a list of the MarketPlace plans in our area.

We Accept this MarketPlace Plan
UnitedHealthcare - Bronze, Silver and Gold 

We Do Not Accept these MarketPlace Plans 
Aetna CVS - offers multiple options.
Ambetter offers several options on and off the Marketplace.   
Anthem Pathway X offers several options, including Bronze, Silver and Gold.  These plans are offered both on and off the Marketplace.   
Medica (includes Wellfirst by Medica or Balance by Medica) offers multiple options.
Oscar Insurance Company offers multiple options.  

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MEDICARE HEALTH PLANS   
          black = we accept these plans unless otherwise noted.      
          Non Par = we do not participate in these plans (you will have no benefits) 
          * / blue  =  We are not contracted, but you probably have out of network benefits. It is your responsibility to know the impact of your out of pocket costs to go out of network.
      

AARP Medicare Advantage from UHC ST: Walgreens PPO  *
AARP Medicare Advantage from UHC ST: Walgreens HMO-POS --- Non-Par
Aetna Medicare Choice and Chois Plus HMO-POS 
Aetna Medicare Gold Advantage HMO-POS 
Aetna Medicare Elite PPO 
Aetna Medicare  SmartFit PPO 
Aetna Medicare Discover Value Plus HMO-POS  .
Aetna Medicare Premier PPO 
Aetna Medicare Assure HMO D-SNP  .
Anthem Medicare Advantage PPO  *
Anthem Medicare Advantage HMO/POS --- Non-Par
Essense Advantage HMO, Select HMO, Plus HMO --- Non-Par
Essence Advantage Choice PPO and Choice Plus PPO  *
Humana Gold Plus - any HMO plan --- Non-Par
Humana Choice - any PPO and PFFS plan  *
Medicare (traditional)
Medicare Supplement - If your secondary card reads 'Medicare Supplement', this works along with your traditional Medicare card.
RailRoad Medicare
United HealthCare (Medicare) Complete Care PPO - CSNP  *
United HealthCare Medicare Advantage PPO    *
United HealthCare GROUP Medicare Advantage PPO   *
United HealthCare GROUP Medicare Advantage HMO --- Non-Par
United HealthCare Dual Complete HMO-POS D-SNP  --- Non-Par
United HealthCare SNP Plans - including Complete Care, Dual Complete, Care Advantage, Nursing Home Plan --- Non-Par

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COMMERCIAL HEALTH PLANS   
           black = we accept these plans unless otherwise noted.      
          Non Par = we do not participate in these plans (you will have no benefits) 
          * / blue  =  We are not contracted, but you probably have out of network benefits. It is your responsibility to know the impact of your out of pocket costs to go out of network. 

Allsavers (UHC)
Ambetter --- Non-Par
Aetna
Aetna Carelink --- Non-Par
Aetna CVS Health --- Non-Par
Aetna IFP (Individual Famly Plans shown as Gold, Sivler or Bronze) --- Non-Par
Aetna HMO
Anthem Blue Access and Blue Access Choice   
Anthem Blue Preferred HMO      referral required
Anthem Blue Preferred PPO     
Anthem FEP (Federal)             
Anthem Alliance network --- Non-Par
Anthem Mercy - If the network listed is Blue Access or Blue Access Choice, we are par.
Anthem Mercy - If the network is listed as Alliance, --- Non-Par   Note: The network is not the same as the plan name.
Anthem Pathway or Pathway X --- Non-Par
Anthem Direct Access --- Non-Par
Anthem Multi-State --- Non-Par  
Balance  (Medica) --- Non-Par
BCBS - (Blue Cross/Blue Shield)  see Anthem
Champus/Champva --- Non-Par
Cigna HealthCare of St., Louis HMO   referral required
Cigna Local Plus      check insurance card regarding referral
Cigna Open Access Plus
Cigna HMO 
Cigna PPO 
Coventry --- Non-Par 
Essence HMO --- Non-Par
Exclusive Choice --- Non-Par
First Health
Golden Rule
Healthlink HMO --- Non-Par 
Healthlink PPO, POS, HMO-OA III * NON PAR -see if your plan has out of network benefits  *
Humana Commercial Products - we participate in CHOICE CARE only
Humana Medicare Supplement
IBEW  (processed by Cigna)
Medicaid or any Medicaid HMO or PPO product --- Non-Par
Mercy Anthem Blue Access Choice - If the network is listed as Blue Access Choice, we are par)
Mercy Anthem Alliance - If the network is listed as Alliance, --- Non-Par 
Medica --- Non-Par
Medico Corp Life Insurance
Meritain
MultiPlan - Non-Par   terminated 09/30/2024
NALC  (processed by Cigna) 
Oscar Insurance Co --- Non-Par
Painters  
PHCS --- Non Par   terminated 09/30/2024
Plumbers & Pipefitters  
Sheet Metals 
Solidarity HealthShare
SSM & SSM CoreSource   --- Non-Par
Tricare for Life Medicare Supplement
Tricare, all other --- Non-Par
UFCW 
UHSS
UMR
Union Pacific RailRoad
United HealthCare: Surest Bind
United HealthCare: Choice & Choice Plus, Allsavers, Core
United HealthCare Compass, Navigate, Charter   referral required
Wellfirst  (Medica) --- Non-Par