How soon do I need to add my newborn to my insurance?
It is your responsibility to inform your employer and insurance carrier of the birth of your child within the first few days of life. Failure to do this within 30 days may result in the insurance company assigning a date other than your child's date of birth as the effective starting date of coverage. If your insurance is an HMO, please remember to choose one of our doctors as your child’s PCP (primary care physician).
What does "Maximum Benefits" mean?
During the first 24 months, your baby will need routine physical examinations including immunizations. Many insurance policies do not cover this “well care” or have a maximum dollar amount (many at $250-$500) resulting in rejections for these claims. You will be responsible for these charges. Please call your insurance company to verify well care coverage. Many of our families are directed to the Health Department where vaccines are provided free of charge.
More about "Well Visits"!
After 36 months, our pediatricians recommend physical examinations annually. Often the insurance plans will only pay for one well visit per year. It is your responsibility to schedule these examinations one year apart. Contact your insurance company to determine whether your child is covered for one well visit per year or calendar year. Also, please note that there is a $25 cancellation fee if a well visit is not cancelled 24 hours prior to the appointment.
What is my "Office Visit Copay"?
Most heath insurance policies require co-pays for office visits. Read your benefit information to determine if the co-pay is applicable for both well and/or sick visits. Our office expects payment of your co-pay at the time of service.
What about "Deductibles" and "Coinsurance"?
In addition to the office visit co-pay, your health insurance policy may have an annual deductible and or coinsurance (out-of-pocket expense) before insurance payment is approved.
Will my child’s immunizations be covered?
The best way to ensure the correct answer to this question is to call your insurance company using the number on the back of your insurance card. Be sure to ask about well child visits (physical exams) including immunization coverage. It is very important to find out if there is a “maximum dollar amount” attached to this benefit. If you reach your maximum benefits, you will be responsible for any charges not covered by insurance. Please feel free to call our billing department with questions or concerns about your insurance. If immunizations are not covered you may obtain them at the Health Department.
Accepted Insurance Plans
- Beaumont Employee health Plan (UMR)
- Blue Care Network
- Blue Cross Blue Shield Traditional
- Blue Cross Blue Shield General Motors
- Blue Preferred PPO (Community Blue)
- Choice Care
- Cigna Managed Care
- Cigna PPO
- Direct Care America PPO
- Federal Blue Cross
- Golden Rule
- Great West
- HAP Alliance Health & Life (EPO, EPA, POS, PPO)
- HAP HMO
- HAP Preferred (EPO, EPA, POS, PPO)
- Health Scope Benefits
- McLaren Commercial HMO (not Medicaid)
- McLaren Commercial POS (not Medicaid)
- Meridian Health Plan
- One Health Plan
- Priority Health HMO & PPO
- PHCS (Private Health Care Systems)
- United Healthcare POS & PPO
- Us Health & Life
ALL HMO PLANS MUST HAVE ONE OF OUR DOCTORS LISTED AS THE PRIMARY CARE PHYSICIAN