Woodbury Pediatrics

Insurance

We accept most insurance carriers. Please have your card with you at the time of your visit. If we file your claim, you are responsible for only the co-pay at the time of visit. If we are not a provider for your insurance, if you are not insured or we do not file with your insurance company, you may be responsible for the entire charge at the time of service.  For information on how to obtain insurance coverage for you and/or your family, please visit www.healthcare.gov.

We accept the following state insurances:
Horizon NJ Health
Amerigroup

We DO NOT Accept the following Insurances:
United Healthcare Community
United Compass
Ameriheath (purchased through Obamacare Website )

It is your responsibility to know what your Insurance Benefits are.  As much as we would like to be able to help you with this, there are too many plans for us to know all of them.  Please check with your benefit provider to see if a service is covered, and we are an in network provider.  You are responsible for all deductible amounts and co-payments. 

If you have an HMO policy, please make sure our Office/Providers name is listed on your card. Please bring your card with you to each visit.

Aetna

Aetna Better Health ……………………………………………..PAR
Aetna Premier Care Network and Aetna Aexcel Plans
Aetna APCN Network…………PAR, Designated Tier
PCP’s Primary Care & Pediatricians……...…PAR & Tier 2
 
 
Advocare specialists…………………PAR, Tier 1
(outside of the “12 Specialties”)
 
The following 12 specialties are PAR but are not designated as APCN, these are all TIER 3
Cardiothoracic Surgery, Cardiology, Gastroenterology General Surgery, Neurology, Neurosurgery, Orthopedics, Otolaryngology/ENT, OB/GYN, Plastic Surgery, Urology, Vascular Surgery
 

Aetna Whole Health  (part of the 2018 Virtua Employee Plan – Virtua Network; all Advocare providers in ALL NJ counties are included in this plan as Tier 1)
Category 1 Category 2 Category 3
Aetna Medicare Plan …………….PAR Aetna Managed Choice …………….PAR Aetna Medicare Plan Open-Access (HMO) …………….PAR
Aetna Select……………………..….PAR Aetna…………….PAR Aetna Health Network Only…………….PAR
Aetna Elect Choice……………….PAR   Aetna Open-Access Elect Choice…………….PAR
Aetna HMO………………………….PAR   Aetna Open-Access (HMO) …………….PAR
Aetna Medicare Prime Pla……PAR   Open-Access Aetna Select…………….PAR
Aetna Whole Health – Virtua Plan – Tier 1…………….PAR    
Category 4 Category 5 Category 6
Aetna Choice POS…………….PAR Aetna Limited Benefits Insurance Plan …………….PAR Aetna Voluntary Group Medical Plan (Indemnity Plan)…….PAR
Aetna Choice POS II…………….PAR Aetna Open Choice (PPO) …………….PAR Aetna Traditional Choice…………….PAR
Aetna Health Network Option…………….PAR    
Aetna Open-Access Managed Choice…………….PAR    

Amerigroup – PAR unless otherwise indicated

Amerigroup Amerivantage Dual (HMOSNP) ………………………………………………..…….…………………………………………………………………………………………………………………………….………………   PAR
(must be PAR with Amerigroup in order to participate with Amerivantage Dual HMOSNP)

AmeriHealth – PAR unless otherwise indicated

Advantage….……………………………………………………NON PAR
(previously called Community Advantage)
Hospital Advantage Plan………………………………….NON PAR Value Network/Value Network Tier 1 plans….. NON PAR
(Advocare is NONPAR with any AmeriHealth plan that has “Value” in the name or on the card)
AmeriHealth Regional Preferred Network ……………….……………………………………………………………………………………….……………………………….………………………………………………………..……. PAR
Platinum
IHC Platinum EPO Regional Preferred …..……….………. PAR IHC Platinum HMO Regional Preferred …..……….…….. PAR IHC Platinum POS Plus Regional Preferred …………….PAR
Silver
IHC Silver EPO H.S.A Regional Preferred……………….…PAR IHC Silver EPO Regional Preferred ……………………………PAR IHC Silver HMO Regional Preferred ……………..…………PAR
IHC Silver POS Plus Regional Preferred ………….……….PAR    
Gold
IHC Gold EPO H.S.A Regional Preferred ……………….…PAR IHC Gold EPO Regional Preferred ..…………………………..PAR IHC Gold HMO Regional Preferred …………………………PAR
Bronze
IHC Bronze EPO H.S.A Regional Preferred ……………….PAR IHC Bronze EPO Regional Preferred …………………………PAR  
 

Cigna

Cigna Choice Fund Open-Access Plus ……………..……… PAR        Cigna Healthcare PPO .……………………….……….…………. PAR           Cigna HMO ……………………..……………………………………... PAR
Cigna Indemnity ……………………………………………..……… PAR Cigna Local Plus …………………………………………………..…. PAR Cigna Network ……………………………………………………….. PAR
Cigna Network Open-Access…………………………………….PAR Cigna Open-Access Plus…………………………………………...PAR Cigna POS or HMO Open-Access………………………………PAR
Cigna POS………………………………………………….……………..PAR Cigna PPO…………………………………………………………………PAR  

Clover

Clover Health Choice (PPO)………………………………………PAR Clover Health Choice Premier (PPO)…………………………PAR Clover Health Choice Value (PPO)…………………………….PAR
Clover Health Classic (HMO)…………………………………….PAR Clover Health Value (HMO)………………………………………PAR  

Horizon Blue Cross Blue Shield of New Jersey

Direct Access Products
Horizon Advantage Direct Access …………………………… PAR Horizon Direct Access ……………………………………..…….. PAR Horizon Direct Access Value ..………………………………… PAR
Horizon Direct Access Value Select ……….…………..…… PAR Horizon Direct Access HSA/HRA ………………………..…… PAR NJ DIRECT10 ……………………………………………………………PAR
NJ DIRECT15 …………………………………………………………… PAR NJ DIRECT1525 ……………………………………………..……….. PAR NJ DIRECT2030 …………………………………………..…..…….. PAR
NJ DIRECT2035 ……………………………………………..……….. PAR NJ DIRECT HD1500 …………………………………………………. PAR NJ DIRECT HD4000 ……………………………………..…………. PAR
EPO Products
Horizon Advantage EPO Bronze ……………………………… PAR Horizon Advantage EPO Silver …………………………………PAR Horizon Advantage EPO Gold……………………………..…… PAR
Horizon Advantage EPO Essentials …………………………. PAR Horizon Advantage EPO HSA/HRA ………………….……....PAR Horizon Patient-Centered Advantage………………..…….PAR
Horizon Patient-Centered Advantage EPO Bronze……PAR Horizon Patient-Centered Advantage EPO Silver………PAR Horizon Patient-Centered Advantage EPO Gold……….PAR
OMNIA℠ ……………………………………………………………….…PAR OMNIA℠ Bronze HSA ……………………………….……………. PAR OMNIA℠ HSA ………………………………….……………………...PAR
OMNIA℠ Gold ……………………………….…………………….… PAR OMNIA℠ Platinum …………………………………….…………….PAR OMNIA℠ Silver ………………………………………….…………….PAR
OMNIA℠ Silver HSA ………………………………………………..PAR    
Horizon Omnia (Advocare is a Tier 1 Provider)
Omnia RWJBarnabas Health (listed as ‘Inner Circle’)..PAR    
Horizon Products
Horizon Access Value …………………………………………….. PAR Horizon HMO …………………………………………………………. PAR Horizon HMO Access ……………………………………….…… PAR
Horizon HMO Access HSA MyWay ……………………….… PAR Horizon HMO Coinsurance/Coinsurance Plus ………….PAR  
Medicare Advantage Products
Horizon Blue Value (HMO) ………………………………………PAR Horizon BCBS Medicare Blue Advantage HMO…NON PAR Horizon Medicare Blue (PPO)………… ……………………… PAR
Horizon Medicare Blue Access (HMO-POS)…………..….PAR Horizon Medicare Advantage NJ Direct (PPO)……..…. PAR Horizon Medicare Blue Group w/Rx ………………………. PAR
Horizon Medicare Blue Patient-Centered w/RX ……….PAR Horizon Medicare Blue Choice w/RX (HMO) …….……..PAR Horizon Medigap Plans –
Horizon Medicare Blue Select (HMO-POS)……….NON PAR Horizon Medicare Blue Value w/RX (HMO) ……………. PAR BCBSNJ 65, BCBSNJ 65 Select, Super 65 …………………. PAR
Horizon POS, PPO & Indemnity Products
Basic Blue℠ Plan A……………………………………………………PAR BCBS Service Benefit Plan ………………………………………..PAR BlueCare® ………………………………………………………………. PAR
BlueCard® PPO ………………………………………………………..PAR Comprehensive Health Plan …………………………………….PAR Comprehensive Major Medical ……………………………….PAR
Federal Employee Program® (FEP®)…………………………PAR Horizon Advantage PPO …………………………………………. PAR Horizon Basic Health Plan A …………………………………….PAR
Horizon Basic Plan A/50 …………………………………………..PAR Horizon Comprehensive Health Plan………………………..PAR Horizon EPO……………………………………………………..……..PAR
Horizon High Deductible Plan C & D…………………………PAR Horizon High Deductible PPO Plan D………………………..PAR Horizon MSA Plan C & D………………………………….……….PAR
Horizon MyWay HRA & HSA………………………………..…..PAR Horizon PPO……………………………………………………………..PAR Horizon Traditional Plan B, C, D…………………………..……PAR
 

Horizon NJ Health of New Jersey

Horizon NJ Health TotalCare (HMOSNP)……………………………………………………………………………………………………………………………………………………………………………………………………………...PAR
(must be participating with Horizon NJ Health in order to participate with)

IBC/Keystone

IBC & Keystone’s Tiered plans…………………………………PAR
(for Keystone Proactive we are Tier 3)
IBC/KHPE Value Network…………………………………NON PAR Community Advantage Network…………………….NON PAR
(previously the Cooper Community Advantage Network)

Qualcare

Emblem Health, Humana and GHI only through Qualcare (meaning if the patient presents with a card that has the Qualcare logo on it, you are PAR with these plans):
Qualcare HMO………………………………………………………….PAR Qualcare Open-Access……………………………………………..PAR Qualcare POS……………………………………………………………PAR
Qualcare PPO……………………………………………………………PAR    
 
Emblem Health, Humana and GHI card with NO Qualcare logo……………………………………………………………………………………………………………………………………………………………………NON PAR
 
Oscar Health through Qualcare…………………………………………………………………………………………………………………………………………………………………………………………………………………………….PAR

Tricare

Champ VA………………………………………………………………..PAR Tricare…………………………………………………………………….…PAR Tricare for Life (PPO)……………………………………………..…PAR
Tricare Prime……………………………………………………………PAR Tricare Standard……………………………………………………….PAR  

United Healthcare/Oxford

ALL United Healthcare Medicare plans…………..NON PAR
(including AARP Medicare Complete)
United Healthcare Community Plan………………...NON PAR United Healthcare Compass plan……………..……..NON PAR
 
United Healthcare All Savers Plans (part of the UnitedHealthcare Choice Plus Network)………………………………………..…………………………………………………………………………………………..PAR
Golden Rule……………………………………………………………..PAR Oxford Freedom Open-Access………………………………….PAR Oxford Garden State POS………………………………………...PAR
Oxford Liberty POS…………………………………………………..PAR Oxford Navigate HMO………………………………………………PAR United Healthcare Choice HMO………………….……………PAR
United Healthcare Choice PPO…………………………………PAR United Healthcare Choice Plus HMO………………………..PAR United Healthcare Choice Plus PPO………….………………PAR
United Healthcare HMO…………………………………………..PAR United Healthcare Open-Access…………………….…………PAR United Healthcare PPO……………………….……………………PAR
United Healthcare Select HMO…………………………………PAR United Healthcare Select PPO………………………………….PAR