KBenefits Insurance Services
Insurance - Medicare - Retirement

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Carrier Networks

Each carriers has multiple Provider & Hospital networks.   Network strength can be defined as how many doctors and hospitals participate within that specific network.   A "strong" network has many doctors and hospitals compared to a "weaker" network that has fewer doctors and hospitals in their network.  As note some networks are NJ only access or may have some Regional Access. 

 


Horizon BCBS of NJ:  Find a Doctor

1)  PPO:   National network ie. blue card
2)  Direct Access:   NJ access with blue card
3)  Advantage EPO:   NJ only access, some plans allow for blue card rider
4)  OMNIA:  NJ, PA, DE access

 

 

Amerihealth of NJ Find a doctor in the network
1)  National Network Available through the Multiplan PHCS National Network for services obtained outside of the Regional Preferred service area.  Not available in the Individual Market.

2)  Preferred Regional:  One of the largest networks of doctors, hospitals, and labs in the state of New Jersey.3 Members have access to participating physicians and providers in New Jersey, Delaware, and Southeastern Pennsylvania

3)  Local Value : The Local Value network currently represents 82% of the New Jersey-based Regional Preferred network, offering individuals and employers a more affordable rate.4 The following plans are a subset of the Local Value network and are designed to offer additional options focused on affordability and high-quality health care coverage.

  • AmeriHealth Hospital Advantage plans allow members to pay lower out-of-pocket costs for hospital and facility services if they use a participating AmeriHealth Hospital Advantage provider.   Tier 2 providers are available through the AmeriHealth New Jersey Local Value network. View Tiered Facilities.

 

  • AmeriHealth Advantage plans are offered in collaboration with the following health systems: AtlantiCare, Cape Regional Medical Center, Cooper University Healthcare, Deborah Heart and Lung Center, Hackensack Meridian Health, and RWJBarnabas Health. Learn more.

 

 

Oxford Find a Doctor
1)   Freedom

2)   Liberty
3)  Garden State Network - NJ access only
4)   Metro Network - NY plans


 

Oscar Insurance:  Find a Doctor

1)  Qualcare in NJ with access to NY:  Mt Sinai network, Montefiore and Long Island Health network

 

Qualcare/APEHP
1)  Qualcare: 
Find a NJ Doctor
2)  CIGNA OA POS PLUS national access:  Find a Out-of-State Doctor
2)  Community Care Network - NJ access only:  :  Find a NJ Doctor

 

Medicare Supplment Plans

*  100% of hospitals in America accept
*  93% of doctors in America accept

 

 

Medicare Advantage Plans
*  Limited to doctors & hospitals
*  MAPD's either have state, regional or national access networks
*  Some MAPD's have out of network benefits.

 

 

 

Christopher S. Kudryk
Benefits Specialist
Call: 732-333-1976
Fax:  732-444-5971
chris@kbenefits.com

KBenefits insurance services provide solutions for small business owners and individuals In NJ, NY, PA and FLA.  Contact KBenefits today and see how we can benefit you and your company.

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