BCBS Empire Pathway Update

PARTICIPATING INSURANCES:

  • AARP MedicareComplete Gated (HMO / requires referrals)
  • AARP MedicareComplete Plan 1
  • AARP MedicareComplete Plan 2
    • Both Plan 1 and 2 have gated versions; cards reflect referral requirements.
  • AARP MedicareComplete Plan 3
  • AARP MedicareComplete Essential
  • AETNA
    • PPO and HMO (referrals required for specialist)
    • MEDICARE ADVANTAGE PPO / HMO - Elite, Premier, Value Plans
    • LOCAL 1199
  • BCBS / EMPIRE
    • PPO
    • HMO
    • GEO BLUE
    • NOW ACCEPTED BY DR. CASTIELLO AS OF 2/1/17
    • EXCHANGE PROGRAMS ACCEPTED FOR BCBS ONLY – EXCLUDING ANY HEALTH PLUS/CHILD HP
      • MEDIBLUE WE ACCEPT - ONLY EXCLUDING IDS WITH (YLR YLV OR VOF)
      • EXCLUDING MEDICAID ADVANTAGE PLANS
  • *CIGNA
    • GREAT WEST / ONE HEALTH (PPO Plan only)
    • RADIOLOGY RESTRICTIONS (see list of approved procedures)
  • CONNECTICARE
  • *EMBLEM HEALTH (GHI / HIP/ HIP HMO)
    • *NO RADIOLOGY FOR HIP*
    • HIP HMO (referrals required for specialist)
    • EXCLUDING ENHANCED CARE PRIME, INBALANCE EPO, HIP EMBLEMHEALTH COMPREHEALTH, VIP PREMIER (HMO) GROUP PLANS & ESSENTIAL PLANS
    • EXCLUDING MEDICAID AND EXCHANGE PROGRAMS (MA=MEDICARE ADVANTAGE)
    • EXCLUDING MEDICARE AND SELECT CARE NETWORKS
  • FIRST HEALTH / COVENTRY
  • MEDICARE
    • Railroad Medicare
    • TRADITIONAL (Part B Only)
  • MEDICHOICE / BEECH STREET
  • *MVP HEALTH CARE
    • CATSCANS ACCEPTED, BUT MUST RECEIVE PRIOR AUTHORIZATION FROM EVICORE
    • EXCLUDING THE FOLLOWING PLAN TYPES: MVPM PLANS (MEDICAID), MVPC (CHILD HEALTH PLUS), MVPMS PLANS (MEDICAID SSI), MVPH (HARMONIOUS HEALTH), MVP LIBERTY & MVP ESSENTIAL PLANS
    • EXCLUDING PODIATRY, DERMATOLOGY, OB/GYN, PEDIATRICS, PREMIERE “PLUS”/EXCHANGE PLANS
  • OXFORD FREEDOM LIBERTY PLANS AND *METRO PLAN EXCHANGE
    • HMO (referral required for specialist)
    • EXCLUDING COMMUNITY/COMPASS PLANS
  • POMCO
  • PRIVATE HEALTHCARE SERVICES (PHCS)/MULTIPLAN
  • SELECTPRO
  • TRICARE - Army ID#
  • UNITED HEALTHCARE
    • EXCLUDING COMMUNITY, COMPASS & EXCHANGE PLANS
  • UNITED HEALTHCARE MEDICARE SOLUTIONS
  • UNITED HEALTHCARE EMPIRE STATE EMPLOYEE PLAN (NYSHIP)
  • UnitedHealthcare MedicareComplete Choice (Eastern) Regional PPO (RPPO) plans

NON-PARTICIPATING INSURANCES:

  • AFFINTY PLAN
  • CARECONNECT
  • EMBLEM HEALTH ENHANCED CARE OR ESSENTIAL PLANS
    • CAN BE IDENTIFIED BY POLICY ID STARTING WITH ANY LETTERS OR HEALTH REPUBLIC PLANS
  • EMPIRE BCBS *HEALTHPLUS* = MEDICAID PLAN
  • FIDELIS
  • HIP EMBLEMHEALTH COMPREHEALTH
  • HEALTHYCT
  • HEALTHSOURCE
  • HUDSON HEALTH (MVP / MEDICAID)
  • HUMANA
  • MAGNACARE
  • MVP PREMIERE PLUS / EXCHANGE / MEDICAID PLANS
  • MVP MEDICAID, CHILD HEALTH PLUS, LIBERTY AND ESSENTIAL PLANS (MVPM, MVPC, MVPMS)
  • MEDICARE ADVANTAGE PLANS
    • EXCLUDING AETNA & AARP MEDICARECOMPLETE PLANS
  • MEDICAID – ONLY ACCEPTED AS SECONDARY TO MEDICARE
  • OSCAR INSURANCE
  • UNITED HEALTHCARE/OXFORD COMMUNITY AND COMPASS PLANS
  • AARP MedicareComplete Mosaic

*NO FAULT POLICY* (SMG IS NOT CONTRACTED WITH ANY NO FAULT INSURANCE COMPANY)

*WORKERS COMP*

  • Scarsdale/Harrison Employees Only