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Insurance Participation

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.

  • 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

  • AAARP MEDICARE ADVANTAGE (UHC)
  • AETNA MA
  • Aetna (Not All Plans)
  • AETNA ASSURE PREMIER PLUS & (HMO D-SNP)
  • AmeriHealth
  • AMERICA’S CHOICE PLAN (PHCS NETWORK) (Physicain only)
  • AVESIS
  • APWU (UHC Network)
  • Bankers Life & Causualty (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 LIBERTH (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)
  • 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 Millenium Network
  • Empire NYSHIP
  • Fidelis (NYNM IPA) All Plans
  • GLOBE LIFE (Formally 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 Concil
  • 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
  • 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

Please note that this list is subject to change, and we recommend contacting your local office or your insurance provider to confirm coverage before your appointment.

If you have any questions about insurance coverage, please don’t hesitate to contact us today. We’re here to help you navigate the insurance process and ensure you receive the care you need.