Q: What's the difference between HMO and PPO?

HMO You always have to see your primary care provider first when you’re experiencing a health issue. Need a referral to an in-network specialist. Must stay in-network to be covered. PPO Freedom to choose providers of your choice. Can choose from in-network and out-of-network providers. In-network and out-of-network will have different costs.

Question 1

What insurance plans do you accept?

Accepted Answer

NeuMed accepts health plans from most insurance carriers as well we will file your claim to help make the process as easy as possible, just like your typical doctor’s office.

We’re currently in-network with the following insurance providers:

Carrier Name	Plan Name
Anthem Blue Cross	Blue Cross PPO (Prudent Buyer)
Anthem Blue Cross Blue Shield	PPO/EPO
Anthem Blue Cross Blue Shield	Advantage PPO
Anthem Blue Cross Blue Shield	Blue Access PPO
Anthem Blue Cross Blue Shield	PPO (Connecticut)
Blue Cross Blue Shield Federal Employee Program	Basic Option
Blue Cross Blue Shield Federal Employee Program	Standard Option
Blue Cross Blue Shield of Illinois	PPO
Blue Cross Blue Shield of Illinois	Blue Edge PPO
Blue Cross Blue Shield of Illinois	BasicBlue PPO
Blue Cross Blue Shield of Massachusetts	Preferred Blue PPO
Blue Cross Blue Shield of Michigan	PPO Plans - Group Enrollees
Blue Cross Blue Shield of Texas	Blue Choice PPO Plan
Blue Cross Blue Shield of Texas	Blue Edge PPO
Blue Cross Blue Shield of Texas	TRS-ActiveCare
Blue Cross Blue Shield of Texas	UT Select PPO
Blue Cross Blue Shield of Texas	Blue Advantage HMO
Blue Cross Blue Shield of Texas	HMO Blue Texas
Blue Cross Blue Shield of Texas	Blue Choice Silver PPO
Blue Cross Blue Shield of Texas	HealthSelectSM of Texas
Blue Cross Blue Shield of Texas	Blue Choice Gold PPO
Blue Cross Blue Shield of Texas	Blue Advantage Silver HMO
Blue Shield of California	Blue Shield of California PPO Network
Cigna	Open Access Plus
Cigna	Cigna PPO
Cigna	Choice Fund Open Access Plus
Cigna	Choice Fund PPO
Cigna	HMO
Cigna	Cigna Open Access Plus In-Network
Cigna	CIGNA HealthCare of Texas, Inc. - Houston
Highmark Blue Cross Blue Shield	BCBS PPO
Humana	National POS - Open Access
Humana	Humana/ChoiceCare Network PPO
Independence Blue Cross	Personal Choice PPO
Medicare	Original Medicare Part A and Part B
Premera Blue Cross	Premera BlueCard PPO/Traditional Network
Superior HealthPlan	STAR (Medicaid)
Tricare	Tricare East Region (Humana Military)
UnitedHealthcare	UnitedHealthcare Choice Plus
UnitedHealthcare	UnitedHealthcare Choice
UnitedHealthcare	UnitedHealthcare Options PPO
UnitedHealthcare	UnitedHealthcare Choice Plus Network - UMR
UnitedHealthcare	Choice Plus Plan with HSA
UnitedHealthcare	UnitedHealthcare PPO (Choice Plus)

Question 2

Do you accept Affordable Care Act (ACA/ObamaCare) plans?

Accepted Answer

We are pleased to participate in a limited number of ACA/Exchange plans that enable us to provide you with the high level of care and service you expect from NeuMed. Our goal is to participate with as many plans as possible, and we expect to continue to expand the list of participating plans over time. See our Insurance page for more information.

Question 3

Do you accept off-Exchange or mirrored ACA plans?

Accepted Answer

NeuMed is only in network with specific ACA-related plans sold via the Health Insurance Marketplace, which are listed above. For individual and family health plans purchased privately (outside of an employer) through an insurance company, broker, or small business group, please be aware that if we’re not in network with their Exchange counterparts, we may not be in network with those plans.

Question 4

What is an out-of-pocket cost?

Accepted Answer

An out-of-pocket cost is the amount of money you are required to pay for healthcare services.

There are 3 primary reasons that you would have to pay money out-of-pocket:

When you haven’t met your deductible.
What you need services your insurance plan doesn’t cover.
When you don’t have insurance.

Question 5

What's the difference between HMO and PPO?

Accepted Answer

HMO

You always have to see your primary care provider first when you’re experiencing a health issue.
Need a referral to an in-network specialist.
Must stay in-network to be covered.

PPO

Freedom to choose providers of your choice.
Can choose from in-network and out-of-network providers.
In-network and out-of-network will have different costs.

Question 6

What do you know about my insurance?

Accepted Answer

Here’s what we know about your insurance and are able to confirm from our end at the time of your visit:

If your insurance is in-network or out-of-network.
The amount of your co-pay.

That’s it.

Please note that it is your duty to know and understand your specific coverage details when receiving urgent care.

Question 7

What does it mean if my insurance is not verified?

Accepted Answer

We are able to verify insurance eligibility in real-time through our platform; however, there may be times when an insurance plan can’t be verified due to the following: The Payer ID not being accurate, the insurance plan is from a third party, and/or the insurance provider eligibility system is not responding

Insurance Information

We are currently in-network with the following providers:

Insurance FAQs