Engaging patients in high-quality, compassionate health care

Important information regarding contracted insurance plans at Boulder Medical Center

  • As a patient, you are responsible for knowing if Boulder Medical Center doctors are contracted with your insurance plan. The best way to confirm this is by contacting your insurance company and/or your Human Resources Department (if your insurance is through your workplace).
  • Boulder Medical Center doctors are not contracted with any Exclusive HMO plans.
  • Any other commercial (non-government Medicare/non-Medicaid) plans that are not listed below may be able to be set up as self-pay plans. Contact the Boulder Medical Center business office prior to making an appointment with your provider so that 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. We do participate in the VA Choice Plan for cardiology services only. Veterans MUST contact the VA directly to determine their eligibility for cardiology services.
  • 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 BMC Business Office staff.
  • Insurance contracts are subject to change without notice.

Boulder Medical Center accepts the following Health Insurance Plans (effective January 1, 2018)

Aetna

  • Ameriben – University of Colorado student needs referral from Wardenburg Health Services at CU.
  • EPO
  • HMO
  • Indemnity NAP
  • NC NAP
  • Open Access
  • POS, POS II
  • PPO, PPO Open Choice
  • QPS
  • Select
  • US Access

Anthem / Blue Cross Blue Shield

  • Anthem HMO (excluding Exclusive, Select and Power Select)
  • Anthem Lumenos PPO (excluding UA NET)
  • Blue Advantage HMO
  • Blue Priority HMO
  • EPO – Patient must confirm with insurance that their Boulder Medical Center doctor is in network
  • Federal Employee Program
  • Gold Direct Access Multi-State – Check with Boulder Medical Center business office
  • HMO Colorado
  • HMO Colorado Guest Membership
  • HMO USA
  • Mountain Exchange – only with referral to Boulder Medical Center
  • Pathways HMO
  • Pathways XHMO
  • POS – Check with Boulder Medical Center business office
  • PPO – Your card must say “Bill Local BCBS” or “PPO” is in the suitcase logo
  • University of Colorado employees
    • High Deductible – Yes
    • Medicare Primary – Yes
    • PPO Extended – Yes
    • CU Exclusive HMO – No. If your insurance card says “Exclusive” at the top, your charges will be private pay
  • WellChoice PPO

CIGNA / Great West Health Plan (GWHP)

  • Connect – *Non-contracted – will be private pay
  • EPO – *Non-contracted – will be private pay
  • HMO – Card must say “Cigna of Colorado”
  • Indemnity – Card must say “Cigna of Colorado”
  • Local Plus – Out-of-network patient’s out-of-pocket expense may be higher
  • Local Plus IN –  *Non-contracted – will be private pay
  • Network – Card must say “Cigna of Colorado”
  • Open Access Plus
  • POS – Card must say “Cigna of Colorado”
  • PPO
  • Surefit – *Non-contracted – will be private pay
  • Vantage –  *Non-contracted – will be private pay

Cofinity

  • PPO

Humana

  • Choice Care PPO
  • HMO Select
  • HMO Premier
  • HMO X – All services must be authorized by Primary Care Physician (PCP) listed on your insurance card
  • Humana Gold Medicare Advantage Plans
  • Humana One
  • National POS Open Access (NPOS)

Medicare

  • Humana Medicare Advantage Plans
  • Medicare part B — Boulder Medical Center accepts patients whose Medicare Part B benefits are administered by Novitas for the Federal Governmen,  with or without any type of Medicare Supplemental or Medigap plan
  • Boulder Medical Center is not contracted with any Medicare Advantage/PFFS plans where benefits are managed by any other commercial insurance companies
  • Medicare Advantage HMO plans do not have out-of-network benefits. These plans are *Non-contracted – will be private pay.
    (i.e. United Healthcare, AARP Medicare Complete Secure Horizons HMO)

Private Health Care Systems (PHCS)

  • PPO
  • Multi-Plan PPO

Rocky Mountain Health Plans

  • CNIC
  • HMO – Patient must confirm with insurance that Boulder Medical Center is in-network.
  • PPO
  • Senior Plans for PERA and Basic

United Healthcare                      

  • All Savers
  • AMS
  • Charter – need Boulder Medical Center Primary Care Physician (PCP) or referral
  • Choice and Choice Plus
  • Compass – need Boulder Medical Center Primary Care Physician (PCP) or referral
  • CORE
  • EPO
  • GEHA
  • Golden Rule
  • Harvard Pilgrim
  • Heritage – River Valley
  • Indemnity
  • Managed Indemnity
  • Medica
  • Navigate and Navigate IHP – need Boulder Medical Center Primary Care Physician (PCP) or referral.
  • Options PPO
  • Oxford
  • POS
  • PPO
  • Select and Select Plus
  • Sierra Health + Life
  • Student Resources
  • UHC Medicare HMO —  *Non-contracted – will be private pay
  • UHC Medicare PPO — Out of network. Patients can be seen but their out-of-pocket expenses may be higher. Patients need to check with UHC for their out-of-network benefits.
  • UMR
  • United Health One
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