Effective April 2016
Boulder Medical Center, P.C.
BMC is contracted with the following Health Insurance Plans:

***PLEASE ALSO NOTE THE FOLLOWING IMPORTANT INFORMATION REGARDING CONTRACTED PLANS***

***PATIENTS ARE ULTIMATELY RESPONSIBLE TO KNOW IF BOULDER MEDICAL CENTER DOCTORS ARE CONTRACTED WITH THEIR INSURANCE PLANS, AND THE BEST WAY TO CONIRM THAT IS BY CONTACTING YOUR INSURANCE COMPANY AND/OR YOUR HR DEPARTMENT, DIRECTLY.

***BMC DOCTORS ARE NOT CONTRACTED WITH ANY EXCLUSIVE HMO PLANS.

 ***ANY OTHER COMMERCIAL (NON-GOVERNMENT MEDICARE/NON-MEDICAID) PLANS THAT ARE NOT LISTED HERE, MAY BE ABLE TO BE SET UP AS SELF PAY PLANS. CONTACT THE BUSINESS OFFICE PRIOR TO MAKING AN APPOINTMENT SO WE CAN WORK WITH YOU TO VERIFY INSURANCE COVERAGE, AND PATIENT BALANCE PAYMENT OPTIONS.

***BOULDER MEDICAL CENTER DOES NOT PARTICIPATE WITH CHAMPUS/TRICARE/TRIWEST OR CHAMPVA PLANS AND CANNOT SET THESE PATIENTS UP AS SELF-PAY.

***NEW-TO-MEDICAID PLAN PATIENTS ARE ONLY ACCEPTED AS EACH PHYSICIAN’S SCHEDULE ALLOWS, AND THOSE QUESTIONS CAN ONLY BE ANSWERED BY EACH PHYSICIAN’S OFFICE STAFF, NOT THE BUSINESS OFFICE STAFF.

AETNA

  • EPO
  • HMO
  • INDEMNITY NAP (but not INDEMNITY w/o NAP)
  • NC NAP
  • OPEN ACCESS
  • POS, POS II
  • PPO, PPO OPEN CHOICE
  • QPS
  • SELECT
  • US ACCESS

ANTHEM / BLUE CROSS BLUE SHIELD

  • CU EMPLOYEES
    • HIGH DEDUCTIBLE — YES!
    • MEDICARE PRIMARY — YES! (2ndry to Medicare)
    • PPO Extended — YES!
    • CU EXCLUSIVE HMO — NO! (Insurance card says “Exclusive” at top)
  • EPO – Patient must confirm with insurance that their Boulder Medical Center doctor is in network.
  • FEDERAL EMPLOYEE PROGRAM
  • GOLD DIRECT ACCESS MULTI STATE — Check w/Business Office.
  • HMO:
    • ANTHEM HMO
    • BLUE ADVANTAGE HMO
    • BLUE PRIORITY
    • HMO COLORADO, HMO COLORADO GUEST MEMBERSHIP
    • HMO USA
    • HMOs NO! — EXCLUSIVE, SELECT, POWER SELECT, BLUE PRIORITY — NO!
    • MOUNTAIN EXCHANGE — only with referral to Boulder Med Center
    • PATHWAYS HMO
    • PATHWAYS XHMO — Patient must pick a BMC doctor as their PCP
      HMO NO! – EXCLUSIVE & SELECT & POWER SELECT – NO!
  • POS Check with Business Office.
  • PPO If card says “bill local BCBS” or has PPO in suitcase logo.
    • ANTHEM LUMENOS PPO (excluding: UA NET)
  • UNICARE — Check with Business Office

CIGNA / GREAT WEST HEALTH PLAN (GWHP)

  • CONNECT — NO!
  • EPO NO! — BMC is not contracted with any CIGNA EPO plans
  • HMO — Card MUST say CIGNA of COLORADO.
  • INDEMNITY
  • LOCAL PLUS – Out-of-network; patient’s out-of-pocket may be higher
  • LOCAL PLUS IN — NO!
  • NETWORK — If card says CIGNA of COLORADO.
  • OPEN ACCESS PLUS
  • POS — If card says CIGNA of COLORADO.
  • PPO
  • VANTAGE — NO!

COFINITY

  • PPO

HUMANA

  • ADVANTAGE — (Non-Medicare)
  • CHOICE CARE PPO
  • HMO SELECT — (excluding: PFFS plans)
  • HMO Premier
  • HMO X — All services must be authorized by PCP listed on patient’s insurance card.
  • HUMANA ONE
  • NATIONAL POS OPEN ACCESS (NPOS)

MEDICARE

BMC accepts patients whose Medicare Part B benefits are administered by Novitas for the Federal Government, with or without any type of Medicare Supplemental or Medigap plan.

BMC does not accept any Medicare Advantage/PFFS plans where benefits are managed by any other commercial insurance companies. The only Advantage plans that BMC accepts is the Rocky Mountain Health Plan Senior Plan.

PHCS – PRIVATE HEALTH CARE SYSTEMS

  • PPO
  • MULTI-PLAN PPO

ROCKY MOUNTAIN HEALTH PLANS

  • CNIC
  • HMO – Patient must confirm with insuracne that their Boulder Medical Center doctor is in network.
  • PPO
  • SENIOR PLANS

UNITED HEALTHCARE

  • ALL SAVERS
  • AMS
  • CHARTER
  • CHOICE & CHOICE PLUS
  • COMPASS – need Boulder Medical Center PCP or referral.
  • CORE
  • EPO
  • GEHA
  • GOLDEN RULE
  • HARVARD PILGRIM
  • HERITAGE — RIVER VALLEY
  • INDEMNITY
  • MANAGED INDEMNITY
  • MEDICA
  • Navigate & Navigate IHP – need Boulder Medical Center PCP or referral.
  • OPTIONS PPO
  • OXFORD
  • POS
  • PPO
  • Secure Horizons HMO — NO!
  • SELECT & SELECT PLUS
  • SIERRA HEALTH + LIFE
  • STUDENT RESOURCES
  • UHC Community Plan — NO!
  • UHC Medicare Advantage PPO — NO!
  • UMR
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