Insurance
The physicians of Glen Medical Associates are contracted with the following insurance companies:
- Aetna PPO/POS
- Blue Cross PPO (except Blue Choice)
- Coventry / Personal Care / First Health – PPO, POS
- Cigna / Great West – PPO, POS
- HFN PPO
- Medicare
- Multiplan/PHCS/Beech Street/PPO Next PPO
- Northshore Employee all non-HMO plans
- Unicare PPO
- United Healthcare PPO (no Core, Compass, Navigate, or Medicare Advantage Plans)
The role of insurance in concierge care:
One of the big questions concierge physicians are asked is, “Do I still need insurance?”
The answer is yes.
Dr. Ficho will bill commercial insurance and Medicare for office visits and medical procedures.
Dr. Ficho’s concierge practice does not replace general health insurance. It is an internal family medicine practice, not a health insurance program. You are advised to continue your PPO, Medicare or other insurance program and your FSA or HSA plan. Neither the fee nor the amenities replace general health insurance coverage.
Plus, it is essential to remember that illnesses can be unpredictable. Should you need to be hospitalized or visit an emergency room, you want to ensure you are covered by insurance.
Will Dr. Ficho be a provider on my insurance plan or for Medicare?
Dr. Ficho intends to remain an in-network provider for many major PPO insurance plans and will bill your insurance directly for professional services that are covered by those plans (Professional services are not covered by your annual fee.). HMO patients are not allowed to participate in a concierge practice per the insurance company contract. If the terms of your insurance plan require a co-pay, Dr. Ficho is obligated to request payment at the time of service. Even if Dr. Ficho is not a provider for your insurance plan, he will attempt to refer you to in-network physicians for any necessary consultations and to in-network facilities for diagnostic tests and hospitalizations, as medically indicated. Those services will likely be covered by your insurance plan.
Dr. Ficho’s office will file your claims with Medicare and your supplemental insurer on your behalf, as required by law. Office visit fees that are not reimbursed by insurance will be the patient’s responsibility.
An important note: neither Medicare nor private insurers will cover your annual fee.