Accepted Insurance Plans

Accepted Insurance Plans

Not all providers are enrolled with every carrier. Please inquire within the specific Memorial Medical Group physician group to ensure your carrier is accepted.

Aetna

  • Aetna for Better Health (HCUSA)
  • Aetna Affordable Health Choices SM (PPO)
  • Aetna Choice POS
  • Aetna Choice POS II
  • Aetna Health Network Only
  • Aetna Health Network Optionc
  • Aetna Medicare Plan (HMO)
  • Aetna Medicare Open Access Plan (HMO/POS)
  • Aetna Medicare Plan (PPO)
  • Aetna Medicare Advantage PFFS
  • Advantra HMO/POS (Medicare Advantage) (Option 1 and Option 2)
  • Aetna Medicaid
  • Aetna Open Access Elect Choice
  • Aetna Open Access HMO
  • Aetna Open Access Managed Choice
  • Aetna Select
  • Elect Choice
  • HMO
  • Managed Choice POS
  • National Advantage Program (NAP)
  • Open Access Aetna Select SM
  • Open Choice PPO
  • Quality Point-Of-Service
  • US Access
  • Aetna Signature Administrators (ASA)

Anthem (Right Choice/BCMO)

  • Blue Access (aka Alliance Program)
  • Blue Access Choice (aka AllianceChoice Program)
  • BCBS Traditional/Indemnity
  • BlueCard Business PPO (aka BlueCard Business)
  • BlueCard Business Traditional/Indemnity (aka BlueCard Business - Indemnity)
  • Blue Access Federal PPO *ID # begins with "R"
  • Blue Preferred Options (PPO)
  • Blue Preferred (aka HMO - Traditional or BlueChoice)
  • Blue Preferred Plus POS (aka HMO Program - POS or BlueChoice POS)
  • Blue Anthem Medicare Preferred Plan PPO
  • Anthem Core/Essential/Preferred Direct Access (PPO)

Blue Cross IL

  • PPO - BCE non par

Cigna

  • HMO
  • POS
  • HMO Open Access
  • HMO Open Access Plus
  • POS Open Access
  • POS Open Access Plus
  • Network
  • Network POS
  • Network POS Open Access
  • Network POS Open Access Plus
  • Network Open Access
  • Network Open Access Plus
  • Flexcare
  • PPO
  • Preferred Provider Access
  • Preferred Provider Access Plus
  • EPO
  • PPO Plus
  • Great West Healthcare HMO/POS/PPO/Open Access (aka One Health Plan)

Coventry Advantra of MO

  • Advantra HMO/POS (Medicare Advantage) (Option 1 and Option 2) - offered through CHC-MO, CHC-IL and CHC-KS)
  • Care Management Resources (CMR)/ASO
  • Coventry Health Care of Kansas HMO/PPO/POS
  • Coventry Health Care of Tennessee HMO/PPO/POS
  • Coventry Health Care of Oklahoma HMO/POS/PPO/ASO
  • Coventry Health Care of Iowa HMO/POS/PPO/ASO
  • Coventry Health Care of Nebraska HMO/POS/PPO/ASO
  • Coventry National Network fka First Health Direct HMO/POS/PPO
  • Coventry One HMO/POS/PPO/PPO Plus - Gold, Silver or Bronze levels
  • First Health Network aka First Health (TPA Carrier) PPO
  • Coventry Healthcare of MO (PPO/ASO/HMO/POS)
  • Coventry Healthcare of IL, Inc (HMO/PPO/POS/ASO)
  • Kansas Advantra Freedom PPO
  • Advantra PPO
  • Coventry Health Care of Missouri (f/k/a GHP) Gold Advantage (Medicare Advantage)

Cox Healthcare Network

Essence (Medicare Advantage) (Advantage HMO, Advantage Plus HMO, Special Needs Plan)

Health Alliance 

  • Health Alliance Medicare HMO
  • Health Alliance Medicare POS

Healthlink

  • Healthlink HMO
  • Healthlink Open Access
  • Healthlink PPO
  • Healthlink POS
  • Unicare Platinum PPO Classic (PPO)
  • Unicare Platinum PPO Classic OA I, II, III (HMO)
  • Healthlink Workers Comp (managed through OccuMed)

Home State Healthplan

Humana

  • ChoiceCare PPO
  • Humana Gold Plus HMO (Medicare Advantage)
  • Humana Choice PPO/Regional PPO (Medicare Advantage)
  • Humana Gold Choice PFFS (Medicare/FULL)

Marketplace/Exchange

  • Anthem Bronze/Silver/Gold Direct Access (PPO)/ Blue Preferred PPO; JWU prefix
  • Cigna Connect - (AKA LocalPlus Bronze/Silver/Gold)

Medicaid MO-IL/MC+

  • Healthy Moms Healthy Kids
  • All Kids
  • IDPA
  • IDPA Secondary
  • Harmony (IL Mcaid HMO)
  • Medicaid MO (aka MO Healthnet)
  • Home State
  • MO Care
  • UHC Medicaid

Medicare/Advantage

  • Medicare IL Part B
  • Medicare MO
  • Medicare Railroad
  • Care Improvement Plus

Missouri Care

Multiplan/PHCS

  • Multiplan PPO
  • Multiplan Shared Savings
  • Open Access
  • Preferred Provider Organization (PPO)
  • Beech Street

Occumed Work Comp EPO

 

Rural Medicaid

  • Medicaid Rural Independent
  • Medicaid Rural Independent Secondary
  • Medicaid Rural Provider
  • Medicaid Rural Provider Secondary

Rural Medicare

  • Medicare Cahaba/WPS Government
  • Medicare Cahaba/WPS Government Secondary
  • Medicare Rural Health
  • Medicare Rural Secondary Mutual Of Omaha

St. John's Health System

  • HMO
  • PPO

TRICARE

  • Tricare-Healthnet PPO
  • Tricare Select Reserve
  • Tricare West
  • Tricare North
  • TriWest

UnitedHealthcare 

  • Choice
  • Choice Plus
  • Select
  • Select Plus
  • Select EPO
  • Options EPO
  • Definity
  • CORE
  • Military and Veterans Product (UMVS)
  • AARP or Medicare Solutions Medicare Complete HMO
  • AARP or Medicare Solutions Medicare Complete Choice Plan 1 PPO
  • AARP or Medicare Solutions Medicare Complete Choice Plan 2 PPO
  • UnitedHealthcare Group Medicare Advantage PPO
  • Group Medicare Advcantage (NPPO, group retiree plan)
  • UHC Medicaid
  • Care Improvement Plus

Zelis Healthcare PPO

Definitions

Health Maintenance Organization (HMO): HMOs offer prepaid, comprehensive health coverage for both hospital and physician services. An HMO contracts with healthcare providers, e.g., physicians, hospitals, and other health professionals, and members are required to use participating providers for all health services. Members are enrolled for a specified period of time. Model types include staff, group practice, network, and IPA. 

Preferred Provider Organization (PPO): Some combination of hospitals and physicians that agrees to render particular services to a group of people, perhaps under contract with a private insurer. The services may be furnished at discounted rates and the insured population may incur out-of-pocket expenses for covered services received outside the PPO if the outside charge exceeds the PPO payment rate. 

Point-of-Service (POS): Also known as an open-ended HMO, POS plans encourage, but do not require, members to choose a primary care physician. As in traditional HMOs, the primary care physician acts as a "gatekeeper" when making referrals; plan members may, however, opt to visit non-network providers at their discretion. Subscribers choosing not to use the primary care physician must pay higher deductibles and copays than those using network physicians. 

Workers' Compensation: A state-mandated program providing insurance coverage for work-related injuries and disabilities.