Optum (New Jersey) accepted insurance plans guide

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.

For help selecting a plan that participates with Optum, please Contact us.

 What if my insurance doesn’t cover my service?

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.

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.

• You will not be billed more than the out-of-pocket maximum limit established by your health plan. This includes the billing of all applicable deductibles, copay and coinsurance.
• 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”.