Insurance

Coverage and Plans

Participating Plans

GIMG participates in most area health plans. View the complete list. We encourage our patients to come to appointments with an understanding of their plan benefits, co-payments, non-covered services, and restrictions, as we ask for payment of any co-pays and non-covered services at the time of your visit.

With the constant changes in healthcare, we strongly recommend checking your insurance plan benefits each year in case of any changes to your coverage. This will help to avoid any unexpected out of pocket costs to you.

Listed are insurance plans with which we participate or can file claims. If you are not sure if we participate with your insurance or have questions regarding what your out of network options may be, please contact your insurance carrier.

Please note that a quote of benefits and/or authorization does not guarantee payment or verify eligibility.

Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service.

Uninsured Patients can use this information to learn more about the various opportunities to become insured.

Aetna

All plans (HMO/POS/EPO/QPOS/MC/PPO) 

  • Aetna Choice
  • POS Aetna Open Access
  • Aetna Select
  • Elect Choice EPO
  • Managed Choice
  • Open Choice PPO
  • Aetna Chickering
  • Principal Life/Aetna
  • Innovation Health/Signature Partners HMO plans
  • Innovation Health/Signature Partners Open Access/Managed Choice plans for Virginia only
  • Innovation Health Medicare Advantage HMO
  • Innovation Health Medicare Voyager PPO

http://www.aetna.com/individuals-families.html#open

Care First Blue Cross Blue Shield

(GIMG are Preferred Providers) and (GIMG are PCMH Plus Providers) 

  • Blue Choice
  • Blue Preferred
  • Federal Employee Program
  • Healthy Blue
  • Indemnity
  • NCAS
  • National Account Out of State PPO (NASCO)

https://member.carefirst.com/individuals/home.page

Cigna
  • PPO/HMO/POS/EPO/ Open Access/Network
  • Cigna Medicare (No New Patients)
  • Connecticut General
  • Great West
  • SAMBA
  • Cigna Connect Network Plans
  • Cigna SureFit Plans

http://www.cigna.com/hcpdirectory/

Johns Hopkins HealthCare

Johns Hopkins US Family Health Plan (USFHP) (A GIMG Physician must be selected as the PCP)

http://www.hopkinsmedicine.org/usfhp/

Medicare Plans

(GIMG accepts established patients who are moving to Medicare coverage. In addition, a few of our Physicians will accept “New Patients” with Medicare Insurance. Please call our office to check who may see Medicare patients)

  • Traditional Medicare Part B
  • Rail-Road Medicare Part B
  • Aetna HMO Medicare
  • Cigna HMO Medicare
  • Innovation Health Medicare Advantage HMO
  • Innovation Health Medicare Voyager PPO
  • United Healthcare Medicare Advantage PPO ONLY – NOT United Healthcare Care HMO

http://www.medicare.gov/

United Health Care
  • Choice Plus
  • Definity
  • GEHA/ One Net (formerly Alliance)
  • Golden Rule
  • MAMSI
  • D.I.P.A.
  • HMO/Direct
  • One Net
  • Optimum Choice HMO/Direct
  • Options PPO
  • UMR
  • UHC Navigate HMO
  • UHC Navigate Balanced
  • UHC Navigate Plus
  • Note – We DO NOT PARTICIPATE with United Medicare HMO Plans
  • Note – We DO NOT PARTICIPATE with AARP Medicare HMO Plans

https://www.myuhc.com/member/prewelcome.do?currentLanguageFromPreCheck=en

Out of Network Coverage

Anthem
  • Anthem PPO Plans: Claims are filed to our local CareFirst carrier and contractual adjustments are made.
  • Anthem Healthkeepers: Healthkeepers is an HMO plan that does NOT have out of network benefits. We cannot submit claims and patients are responsible for payment in full at time of service.
Tricare
  • Tricare Prime requires members to contact their MTF to obtain an Authorization prior to being seen. Claims will be processed as POS and subject to the $300 deductible and cost share. As a non-participating provider, GIMG does not accept assignment on claims filed with Tricare and therefore your out of pocket cost may be higher.
  • Tricare Standard does not require prior authorization. A $300 deductible and cost share will apply.

http://www.mytricare.com/internet/tric/tri/mtc_nbene.nsf

Other Non-Participating Plans
  • AARP Medicare Replacement HMO
  • Anthem Healthkeepers HMO Plans
  • First Health/Coventry
  • Humana
  • Kaiser
  • Multi Plan
  • Mutual of Omaha
  • Oxford Health
  • PHCS
  • United Health Care Medicare Replacement HMO 

Plans we do not participate with but can file claims:

While we do not participate with the following insurance plans, we can still submit your claim if you have out of network benefits. However, GIMG does not accept assignment and you may experience higher out-of-pocket costs because we are non-participating provider.

If we do not participate in your health plan, we are still happy to see you. Most insurance plans have coverage for patients who see doctors not in their network or participating with their plan. This is called “out of network” benefits. If you have out of network benefits, you may have to pay a deductible and co-pay for services by a non-participating provider. Consult with your insurance provider about your out of network benefits.

Medicare

GIMG accepts our established patients who are transitioning to Medicare coverage.