Insurance Plans
Memorial Healthcare System Contracted Health Insurers and Networks
Contracted Health Insurers as of January 1, 2021
Click on the Health Insurer’s name for direct access to Health Insurer’s website.
Health Insurers |
Participating Products |
Excluded Products |
---|---|---|
HMO / PPO / POS / Medicare HMO / Medicare PPO / Aetna Better Health |
Excludes Medicare PFFS |
|
Allianz Global Assistance | International | |
Amerigroup | Healthy Kids / Long Term Care |
Excludes Medicaid & Medicare |
AvMed | All Products |
|
AXA Assistance USA, Inc. |
International | |
Axis Services Inc. | International |
|
Beacon Health Strategies, LLC f/k/a Psychcare |
Behavioral Health | |
Better Health, LLC |
Medicaid | |
Blue Cross Blue Shield | See Florida Blue | |
CMN Global Inc. (CMN) f/k/a Canadian Medical Network |
International | |
CarePlus | Services only at Memorial Hospital Pembroke or Memorial Pembroke 24/7 Care Center |
Excludes all other Memorial Facilities |
Cenpatico Behavioral Health |
Behavioral Health |
|
Choice Medical Management |
Workers' Compensation |
|
CIGNA | All Products |
Excludes Health Spring |
CIGNA Behavioral Health |
Behavioral Health |
|
Community Care Plan (CCP) |
All Products | |
Concordia Behavioral Health |
Behavioral Health |
|
CorVel | Workers' Compensation |
|
Coventry / First Health |
PPO & Workers' Compensation |
|
Coventry |
See Aetna |
|
Desjardins Financial Security |
International | |
Devoted Health | Medicare | |
Dimension Health |
PPO | |
Employer's Choice Network |
Worker's Compensation | |
Florida Blue (Blue Cross Blue Shield/Health Options) | HMO / PPC / Traditional Blue / BlueSelect / Medicare HMO / Medicare PPO / Workers' Compensation / myBlue / Simply Blue | Excludes Medicare PFFS, Miami Dade Blue |
Florida Community Care | Medicaid | |
Florida Health Administrators |
PPO & Workers' Compensation |
|
Focus Healthcare Mgmt |
Workers' Compensation | |
Freedom Health |
Medicaid | Excludes Medicare |
Gallagher Bassett Services | Worker's Compensation | |
Global Health Claim Services |
International | |
Guardian Life of Caribbean | International | |
Health Options | See Florida Blue | |
HealthSun Health Plans | Medicare | |
Heritage Summit Healthcare of Florida |
Workers' Compensation | |
Humana | HMO / EPO / PPO / POS / Medicare HMO / Medicare PPO / Medicare PFFS / Medicaid / Tricare |
|
Humana Veterans Healthcare Services | All Products | |
Independent Living Systems (ILS) | Long Term Care | |
JIPA Network, LLC | International | |
Longevity Health Plan | Medicare | |
Magellan Health Services | Behavioral Health / Magellan Complete Care | |
Managed Health Network | Behavioral Health | |
Mental Health Associates | Behavioral Health | |
MMM of Florida f/k/a Health Advantage of Florida | Medicare HMO | |
Molina | Medicaid / Molina Marketplace | Excludes Medicare |
National Healthcare Solutions | International | |
Neighborhood Health Partnership | All Products | |
New Directions Behavioral Health | Behavioral Health | |
Olympus Managed Healthcare | International | |
Oscar Insurance Company of Florida | Exchange / Medicare | |
Plotkin Consulting | International | |
Prestige Health Choice |
Medicaid | |
Prime Health Services, Inc. | Workers' Compensation | |
Quality Health Management | International | |
Rockport Healthcare Group | Workers' Compensation | |
Simply Healthcare Plans | Medicare / Medicaid / Clear Health Alliance | |
Solis Health Plans | Medicare | |
Star Healthcare Network, Inc. | International | |
Staywell | See Wellcare | |
Sunshine Health Plan | Medicaid / Child Welfare Plan / Ambetter | Excludes Healthy Kids |
Three Rivers Provider Network (TRPN) | PPO & Workers' Compensation | |
TourMed | International | |
Travel Insurance Coordinators | International | |
Tricare (Humana) | All Products | |
United Behavioral Health | Behavioral Health | |
United Healthcare | HMO / EPO / PPO / Medicaid / Medicare HMO / Medicare PPO | Excludes Medicare PFFS |
Wellcare | Medicaid / Medicare | Excludes Healthy Kids |
Woodall & Broome, Inc. | Workers' Compensation | |
World Medical Care |
International |
|
World Secure Assistance | International | |
World Travel Protection | International | |
Worldwide Managed Care Partners |
International |
The Health Insurer website links are provided for your convenience and in accordance to Florida Statute 395.301.
Please know:
- Services may be provided in the hospital by the facility as well as by other healthcare practitioners who may separately bill the patient;
- Health care practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organization as the hospital;
- Prospective patients should contact the health care practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as a network provider or preferred provider.
Contracted Networks as of January 1, 2021
Networks | Participating Products | Excluded Products |
Beech Street/Viant1 | PPO & Workers' Compensation | |
Multiplan1 | PPO | |
Private Healthcare Systems (PHCS)1 | PPO |
1The following companies administer network services.
Contracted Transplant Networks as of January 1, 2021
Networks | Participating Products |
Aetna Institutes of Excellence (AIE) | Pediatric Heart (*COE), Adult Heart (*COE), BMT (*COE), Adult Kidney |
Blue Cross and Blue Shield Blue Distinction Centers for Transplant |
Adult Heart (*COE), Adult Kidney (*COE) and Pediatric Heart (*COE) |
Cigna Lifesource Transplant Network | Pediatric Heart (*COE), Adult Heart (*COE) |
OptumHealth Care Solutions Transplant Network | Pediatric Heart (*COE), Adult Heart (*COE), BMT (*COE), Adult Kidney, Pediatric Kidney |
*Center of Excellence (COE)
The Health Insurers and Networks listed above are contracted as of January 1, 2021. If your Health Insurer or Network is not listed above, Memorial Healthcare System is not under contract with your Health Insurer or Network.
To ensure that your Health Insurer or Network allows access to care at Memorial Healthcare System and to verify any benefit exclusions, please refer to the Member Services Department of your Health Insurer or Network and your plan coverage documents.
Health Insurer or Network members should contact the plan for specific product names associated with the participating products described above.
Memorial Healthcare System does not participate in some Medicare Supplement plans. Check with Medicare Supplement plan for its participating network.
Please note: Memorial Healthcare System will provide you with emergency medical care regardless of your plan.