Insurances
Insurance We Accept
SightMD is committed to providing the highest quality eye care to our patients. We want you to get all of the benefits you are eligible for from your health insurance coverage. Many health insurance plans require a referral from your primary care physician prior to consultation with a specialist. In addition, most plans also require preauthorization before any type of surgical procedure or laser treatment. It is your responsibility to obtain the required referral from your primary care physician. Failure to obtain a referral or preauthorization, if required, will result in your health insurance denying payment for our services. In this case you will be held financially responsible for all services obtained through our office.
Our ophthalmologists and optometrists participate in most insurance plans. Below is our present participation list. Coverage varies by doctor to get more information about which insurance plans are accepted by their doctor please reach out to us directly. If your plan is not part of this list, please let us know. We will gladly review your plan with you to see if we are on panel and if not we can go over financing options with you.
Connecticut
AETNA
AETNA BETTER HEALTH
AMERIHEALTH ADMIN OF NJ
AMERIHEALTH CARITAS NORTHEAST
AMERIHEALTH COMMUNITY HEALTH CARE
AMERIHEALTH CARITAS VIP CARE
CAPITAL BLUE CROSS (KEYSTONE CENTRAL)(SENIOR BLUE)
CENTRAL PA TEAMSTERS
CIGNA
CIGNA HEALTHSPRINGS
COVENTRY
DEVON
FEDERAL BLUE SHIELD
FIRST HEALTH NETWORK
GATEWAY
GEISINGER
TOWER HEALTH PPO
TRICARE
HEALTH PARTNERS
HIGHMARK BLUE SHIELD (FREEDOM BLUE)
HORIZON NJ
HUMANA
INDEPENDENCE ADMIN
INDEPENDENCE BC
KEYSTONE FIRST & KEYSTONE 1ST VIP
MEDICAL ASSISTANCE ( medicaid Promise)
MEDICARE
MULTIPLAN
TEAMSTERS
PA HEALTH & WELLNESS ALL WELL
RAILROAD MEDICARE
UNITED HEALTHCARE
UPMC
VIBRA
QUALCARE
WORKMANS COMP
VISION PLANS
ADVANTICA
AVESIS
SUPERIOR/BRAVO/BLOCK
DAVIS
EYEMED
NVA (PVI)
ENVOLVE
SPECTERA
VBA
New Jersey
AAARP MEDICARE ADVANTAGE (UHC)
AETNA MA
Aetna (Not All Plans)
AETNA ASSURE PREMIER PLUS & (HMO D-SNP)
AmeriHealth
AMERICA’S CHOICE PLAN (PHCS NETWORK) (Physician only)
AVESIS
APWU (UHC Network)
Bankers Life & Casualty (Secondary to Medicare)
Blue Cross Blue Shield/Local (PPO, EPO, HMO & any out of state plans) Horizon Network
Blue Cross Blue Shield (RWJBarnabas -Tier1)
Brighton Health (MAGNACARE)
Champva
CHOICE EPO (UHC)
CHOICE PLUS HMO (UHC)
CHOICE POS (UHC)
CIGNA/CIGNA OPEN ACCESS –Not All Plans (Cigna Vision Thru VSP or EyeMed Network)
CIGNA (CCD) TIER 1
CIGNA MEDICARE HEALTHSPRINGS
Clover Health (Medicare Advantage)
COMPASS EPO (UHC)
COMPASS EXCLUSION (UHC)
COMPASS HMO/HMO (UHC)
COMPASS POS (UHC)
Consumer Health Network PPO (CHN)
Empire Plan United HealthCare
Empire Medicare Advantage
Genworth Trust Life (Medicare Supplement)
GPA – TPA (MULTIPLAN / PHCS
Horizon BCBS Medicare Advantage
Horizon BCBSNJ – (tier 1 for Horizon Omnia)
Humana_Medicare_PPO, HMO, FFS, Gold Plus, Gold Choice_(QualCare Network)
HUMANA-TRICARE
IE Shaffer (Horizon Network-Bule Card)
INDECS – TPA (MULTIPLAN / PHCS
Insurance Administrator of America (Cigna Network PPO Plan)
Insurance Design Administrators (IDA)
Integrity Health (Aetna Network)
LOOMIS Company-TPA (CIGNA NETWORK)
Longevity Health (Medicare Advantage Plan)
MailHandlerns (Aetna Network)
MAGNACARE
MEDICARE
MEDICARE RR
Mertain (Aetna Network)
Monumental Life (Medicare Supplement)
MULTIPLAN/PHCS (Not all Plans)
Mutual of Omaha (Medicare Supplement)
NALC (Care Allies-CIGNA NETWORK)
NAVIGATE EPO (UHC)
NAVIGATE HMO/HMO PLUS (UHC)
NAVIGATE POS (UHC)
NEIHBP (EyeMED Network)
NVA
OSCAR (AVESIS Network)
OXFORD FREEDOM (UHC)
OXFORD GARDEN STATE (UHC)
OXFORD LIBERTY (UHC)
OXFORD METRO (UHC)
QUALCARE
Secure Horizons (UHC-Medicare Advantage)
SELECT EPO (UHC)
SELECT PLUS HMO (UHC)
SELECT PLUS POS (UHC(
Spectera (UHC)
Tricare for Life (nonpar for Tricare North)
United HealthCare/UMR (Not ALL Plans)
University Health Plan (UHC Network)
US Family Health Plan (USFHP) -TRICARE HMO & PRIME BENEFIT
United HealthCare Group Medicare Advantage
VACCN Community Care (UHC Network)
VSP
WellCare Health Plan (MCO -Medicare)
New York
AARP
Aetna-Signature Admin Plan GEHA
Affinity/ Molina Healthcare – All Plans- Child Health Plus, Essentials & Medicaid.
Advantra Freedom (Coventry Network)
Aetna ALL Plans/ including banner
Blue Cross Blue Shield/Local (PPO, EPO, HMO, CORE & any out of state plans) PREFIXES NIW, VQA, ZYL, ZVF, CJL, H9N, BKT
Blue Cross Blue Shield Pathway (Exchange)
BCBS Empire Mediblue (HMO) prefix AAN
BCBS Empire Mediblue Plus (HMO) prefix VOF
BCBS Empire Mediblue Services (HMO) prefix VOF
BCBS Empire Mediblue Choice (HMO-POS) prefix VOF
BCBS Empire Mediblue Select (HMO) prefix M8H
BCBS Empire Mediblue Extra Select (HMO) prefix M8H
BCBS Empire Mediblue Services Select (HMO) prefix M8H
BCBS Empire Mediblue Freedom (PPO) prefix XLU
BCBS Empire Mediblue Access (PPO) prefix VOG CFT, KIH, YXE, BAW, XNU
BCBS Empire Mediblue Dual Advantage (HMO D-Snap) prefix JWX,AAN,VOF, M8H, XLU, VOG, E6D
BCBS Empire Mediblue Dual advantage Select (HMO D-Snap) prefix E6D
Blue Cross Blue Shield HealthPlus Gatekeeper
BCBS/Healthplus (JLJ Plan through Superior)
Beech Street (Multiplan/ PHCS)
Brighton Health Plan- now Healthcomp Northwell Direct TIER 1 ( includes IBA, Allied, & Whole Health web TPA )
Centerlight Healthcare (Pace Plan)
Center Plan for Healthy Living NYNM ( medicare advantage plans) HMO, HMO SNP’S
Champva
Cigna -ALL PLANS / (Only Daniel H. Cook plan must be 18 years & younger only ) & NO Cigna Vision
ConnectiCare (Emblem)
Coventry / First Health/ Community Care Aetna
Create Health Plan – includes-Flex, Long Island
Elderplan ( NYNM IPA)
Emblem / HIP
Emblem / GHI
Emblem Select Care (Exchange)
Emblem Millennium Network
Empire NYSHIP
Fidelis (NYNM IPA) All Plans
GLOBE LIFE (Formerly First United American Health)
Health Care Partners
Healthfirst Child Health Plus
Healthfirst Essential Plan
Healthfirst Medicare
Healthfirst Signature (HMO)
Healthfirst Medicaid
Healthfirst Leaf Plans
Healthfirst EPO Plans
Health Now
Humana PPO & POS ( Through GHI )
Humana, Choice Care (Gold plus HMO) & Medicare PPO -Northwell IPA
Husky Health
Land of Lincoln Health (Multiplan/PHCS)
Local 1199 ( thru Aetna) (NYC locations direct with local 1199)
Magnacare
Medicaid
Medical Indemnity Fund
Medicare
MERITAIN HEALTH (AETNA)
MetroPlus
Multiplan / PHCS/ Medicare advantage plan PPO & HMO
MVP (Westchester county only)
NALC (National Association of Letter Carriers)
No Fault
Northwell-Healthcomp Northwell Direct TIER 1 ( includes IBA, Allied, & Whole Health web TPA ) formerly Brighton Health Plan
Northwell-Empire BC Tier 2 (includes all locals)
One Health Plan (Great West) Cigna
Oscar
Oxford Freedom
Oxford Liberty
Oxford Metro
Partners Health Plan – Northwell
Partners Health Plan -NYNM
POMCO (UHC)
Railroad Medicare
The New York Hotel Trade Council
Tricare
United Healthcare ( Including Optum Surest )
United Healthcare Compass (Exchange)
United Healthcare Choice Plus, Select Plus HMO & POS
United Healthcare Community
United Healthcare Community Essential Plan
United Healthcare AARP Medicare Complete Essential (HMO)
United Healthcare AARP Medicare Advantage Value Care (HMO- POS)
United Healthcare AARP Advantage Value Care PPO
United Healthcare AARP Medicare Complete Mosaic (HMO & PPO )
United Healthcare Medicare
United Healthcare Dual Complete (HMO SNP)
United Healthcare Group Medicare Advantage (HMO)
United Healthcare Group Medicare Advantage (PPO)
United Healthcare UMR
US Family Health Plan – through Tricare Military
Veterans Health Choice – through Healthnet
VNSNY Choice Medicare
Vytra/ EMBLEM
WebTPA Claims- Whole Foods Market Whole Health Medical Plan- uses the Aetna network of Dr’s
Wellcare ( NYNM IPA)
Workers Compensation
VISION PLANS
Davis Vision Routine Plan ( including Met Life )
Eye Med Vision (Select and Access Only)
NVA Nation Vision Plan Routine
SUPERIOR VISION ROUTINE
Pennsylvania
AETNA
AETNA BETTER HEALTH
AMERIHEALTH ADMIN OF NJ
AMERIHEALTH CARITAS NORTHEAST
AMERIHEALTH COMMUNITY HEALTH CARE
AMERIHEALTH CARITAS VIP CARE
CAPITAL BLUE CROSS (KEYSTONE CENTRAL)(SENIOR BLUE)
CENTRAL PA TEAMSTERS
CIGNA
CIGNA HEALTHSPRINGS
COVENTRY
DEVON
FEDERAL BLUE SHIELD
FIRST HEALTH NETWORK
GATEWAY
GEISINGER
TOWER HEALTH PPO
TRICARE
HEALTH PARTNERS
HIGHMARK BLUE SHIELD (FREEDOM BLUE)
HORIZON NJ
HUMANA
INDEPENDENCE ADMIN
INDEPENDENCE BC
KEYSTONE FIRST & KEYSTONE 1ST VIP
MEDICAL ASSISTANCE ( medicaid Promise)
MEDICARE
MULTIPLAN
TEAMSTERS
PA HEALTH & WELLNESS ALL WELL
RAILROAD MEDICARE
UNITED HEALTHCARE
UPMC
VIBRA
QUALCARE
WORKMANS COMP
VISION PLANS
ADVANTICA
AVESIS
SUPERIOR/BRAVO/BLOCK
DAVIS
EYEMED
NVA (PVI)
ENVOLVE
SPECTERA
VBA
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