KBenefits Insurance Services
Provider Networks

Provider Networks:  How to ask if your doctor In-Network?

 

You NEVER want to ask if your doctor accepts an insurance carrier,
You ALWAYS want to know if they accept the insurance carriers' Network, in-network

 

Horizon BCBS is just an insurance carrier as is Amerihealth, Oxford, Aetna, Oscar or Wellcare.
You do not call and ask if they take Horizon BCBS, you ask if they accept Horizon OMNIA, In-network.

  • Horizon BCBS:  Advantage, OMNIA, Patient-Centered, PPO, PPO Bluecard
  • Amerihealth:     Advantage, Hospital Advantage, Local Value, Preferred Regional, National, Cooper
  • Oxford has Metro, Liberty, and Freedom network
  • Oscar uses the Qualcare network
  • Aetna uses AWH (Aetna Whole Health), OAEPO, OAPPO, and a few others.
  • Wellcare uses the Ambetter network

 

Network Strength:  How many doctors are expected to be In-Network?

 

1) Oscar/Qualcare:            

Excellent

2) Horizon OMNIA:            

Very Good

3) Oxford/UHC Metro:        

Pretty Good

4) Amerihealth Advantage:

Okay

5) Wellcare/Ambetter:        

Limited - Hit or Miss

6) Aetna AWH:                   

Limited - no network in Monmouth & Ocean County

 

 

Medicare Networks: For people over 65 years / under 65 if disabled for over 2 years

  • BEST:  Medicare A & B is called Original Medicare. This network is the best.
    Nationwide access - 100% of Hospitals and 95% of Doctors accept Medicare A & B – Original Medicare
    It doesn’t matter the name of the Medicare Supplement carrier because you use the Medicare A & B network.

     
  • LIMITED:  Medicare Advantage plans:  You have to know the carrier plan name and the exact network name.

KBenefits Insurance Services
Employee Benefits

Individual Health Insurance
Medicare Plan Options

 

Christopher S. Kudryk
Insurance Specialist
chris@kbenefits.com
732-333-1976

KBenefits specializes in health, dental, vision, life and medicare insurance for employers and individuals in NJ & NY.

Thank you for your referrals!
Referrals are the cornerstone of our business.  Let us know if we can be of further assistance to you or someone you know.  Glad to be of service
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