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Optum accepted insurance plans guide

Map pinThis page contains accepted insurance details for patients in New York. Patients in New Jersey can view our NJ accepted insurance plans guide.

For patients visiting our Optum Urgent Care centers in Nassau, Suffolk, and the New York City boroughs, please browse our accepted plans for Urgent Care.

AttentionWe want to inform you that we have gone out of network with the following:

  • All Fidelis/Ambetter/Wellcare plans: Effective January 1, 2026
  • Cigna/Healthspring Medicare Advantage: Effective January 31, 2026
  • HealthFirst: Not accepted at locations in Manhattan, Queens, the Bronx, Brooklyn, Staten Island, or Long Island, except for radiology and imaging services in Brooklyn, NY.

Insurance Plans

Aetna
Additional details

Non-participating with Aetna Better Health and Aetna Medicare Individual plans at locations in the Bronx, New York, Dutchess, Putnam, Ulster and Westchester Counties.
Non-participating with Aetna Medicare Signature Care (HMO).

Affinity by Molina Healthcare
Additional details

Non-participating with Molina Healthcare Plus-HARP.

Anthem Blue Cross Blue Shield (formerly known as Empire Blue Cross Blue Shield)
Additional details

Non-participating with Blue Priority Network.

CDPHP
Additional details

Non-participating with Medicare, Essential, Child /Family Health Plus and Medicaid Plans. No plans accepted at locations in Manhattan, Queens, the Bronx, Brooklyn, Staten Island and Long Island.

Centivo
Cigna
Additional details

Non-participating with Cigna Local Plus and Medicare Plans (now known as Healthspring) as of February 1, 2026.

Consumer Health Network(CHN)
Coventry
Emblem Health(including GHI, HIP, and NYCE)
Additional details

Non-participating with Medicare Plans (known as VIP), Select Care and Millenium Networks.

Empire Plan(NYSHIP)
Fidelis
Additional details

Non-participating as of January 1, 2026.

First Health Network
HealthFirst
Additional details

Not accepted at locations in Manhattan, Queens, Bronx, Brooklyn, Staten Island, and Long Island, except for radiology and imaging services in Brooklyn, NY.

Humana
Local 1199
Additional details

Not accepted at Manhattan locations.

MagnaCare
Medicaid (NY)
Additional details

Effective January 1, 2026, we no longer accept new Medicaid patients.

Medicare (Traditional Medicare & Railroad Medicare)
Metroplus
Additional details

Accepted only by limited providers at locations in Brooklyn, Queens and Manhattan. Contact your plan to confirm individual provider’s participation.

Mutliplan PPO
MVP Healthcare
Additional details

Non-participating with Essential and Premier Plans.

Not accepted at locations in Brooklyn, Queens and Long Island.

Northwell Direct
Oscar
Oxford
Additional details

Non-participating with Metro Plan Non-AARP Medicare at locations in the Bronx, New York, Dutchess, Putnam, Ulster and Westchester Counties.

TRICARE (authorized non-network provider)
Additional details

Non-network provider.

UMR
United Healthcare
Additional details

Excludes Mosaic & Community Plan. Charter, Compass, and Core Plans not accepted at locations in the Bronx, Manhattan, Dutchess, Putnam, Ulster and Westchester Counties.

Not sure whether you’re in-network?

Optum accepts most major health insurance plans. Before selecting a provider, please check with your insurance company to verify your eligibility and coverage to ensure the provider participates in your plan.

If your health insurance provider is not listed among our accepted plans, the services are likely considered “out-of-network”, and you may be responsible for a greater out-of-pocket expense. If you do not currently have insurance coverage, your visit will be considered self-pay.

What is self-pay?

Self-pay means you are financially responsible for the full cost of your medical services at the time of your visit. This applies to patients who are uninsured or whose insurance is considered out-of-network – meaning we do not have a billing agreement with your insurance company. A self-pay waiver will be required if your insurance does not participate with Optum. Following your visit, you will also need to submit the claim to your insurance company for potential reimbursement.

We strive to provide transparent pricing and will work with you to ensure you understand the costs associated with your care. If you have any questions about self-pay rates or need assistance, please contact our front desk or billing department prior to your appointment.

What if my insurance doesn’t cover my service?

If you are out-of-network or choosing to pay out of pocket, services are still available. Here’s what you need to know:

  • You have the right to request a good faith estimate of expected charges prior to receiving services.
  • In compliance with the “No Surprise Act”, a patient is held harmless from the cost of unanticipated out-of-network bills.

Contact us if you have questions or need more information about participating plans, billing or the “No Surprise Act”.