Optum (New Jersey) accepted insurance plans guide
This page contains accepted insurance details for patients in New Jersey. Patients in New York, please visit our New York accepted insurance plans guide.
New Jersey insurance plans
Optum accepts most major insurances, including:
Optum (New Jersey) accepts most major insurances, specifically:
- Aetna: Aetna Whole Health Plans, Aetna Standard Plans, Aetna Open Access Plus Plans, Aetna HealthFund Plans, Savings Plus Plans, Aetna with Innovation Health Plans, National Advantage Program (NAP), Aetna CVS Health Plans, Aetna Assure Premier Plus Plan, Medicare Advantage Individual and Group Plans, non-participating with Aetna Better Health (Medicaid)
- Amerigroup New Jersey, Inc., dba Amerigroup Community Care (now know as Wellpoint, see below)
- AmeriHealth New Jersey: Local Value Network (including AmeriHealth Advantage & AmeriHealth Hospital Advantage) (Tier 2), Regional Preferred Network, Value Plus Network
- Centivo
- Cigna: HMO, POS, PPO, EPO, Cigna Courage Medicare (HMO), Cigna Preferred Medicare (HMO), Cigna True Choice Medicare (PPO), Cigna True Choice Savings Medicare (PPO), Cigna True Choice Plus (PPO), Oscar, Great West
- Clover Health
- Consumer Health Network
- Empire BCBS: Participating through the Blue Card Program
- Fidelis Care (formerly known as WellCare): NJ Family Care
- First Health: Participating through Aetna Network
- GHI: Secondary to Medicare only, non-participating through Emblem and Comprehensive Benefits Plan (CBP)
- Horizon Blue Cross Blue Shield of New Jersey: Direct Access, EPO, HMO, POS, PPO, Indemnity, OMNIA Health Plans, Braven Medicare Advantage Plans, Federal Employees Program (FEP), State Health Benefit Program (SBHP)/School Employees’ Health Benefits Program (SEHBP), Horizon NJ Total Care (HMO D-SNP)
- Horizon NJ Health: NJ Family Care, Horizon NJ Total Care (HMO D-SNP)
- Humana
- Local 1199: Participating through the Aetna Network
- Magnacare
- Medicaid
- Medicare: Including Railroad Medicare
- Multiplan
- Qualcare
- Tricare (authorized non-network provider)
- United Healthcare: EPO, HMO, POS, HMO Plus, PPO, (non-participating w/ Compass & Indemnity) Nexus ACO, Veterans Affairs CCN, AARP Medicare Advantage Plans, Erickson Medicare Advantage Plans, UnitedHealthcare Medicare Advantage Plans, UHC Community Plan (including NJ Family Health & Dual Complete), Oxford (including Liberty, Freedom & Metro)
- US Family Health Plan
- Wellcare: Wellcare No Premium (HMO-POS), Wellcare Dual Liberty (HMO D-SNP), Wellcare Assist (HMO), Wellcare No Premium Focus (HMO), Wellcare Patriot No Premium (HMO), Wellcare Giveback (HMO), Wellcare Low Premium Open (PPO)
- Wellpoint (formerly known as Amerigroup Community Care) NJ Family Care, Amerivantage Balance (HMO), Amerivantage Dual Coordination (HMO D-SNP), Amerivantage Dual Secure (HMO-POS D-SNP), Amerivantage ESRD Care (HMO-POS C-SNP), Amerivantage Choice (PPO), Amerivantage Classic (HMO)
New Jersey urgent care insurance plans
Optum accepts most major insurances, including:
- Aetna
- Aetna Better Health
- America’s Choice Provider Network
- Amerigroup NJ (now know as Wellpoint)
- Amerihealth NJ
- Cigna (non-participating w/ Cigna Medicare Plans)
- Consumer Health Network (CHN)
- Coventry
- Devon
- Fidelis Care (formerly known as WellCare)
- First Health
- Geisinger Health Plan (Southern NJ locations only)
- HealthSmart Payor Organization
- Horizon Blue Cross Blue Shield of New Jersey
- Horizon NJ Health
- Imagine Health
- Independence Blue Cross
- Independent Medical Systems (IMS)
- Intergroup
- MagnaCare
- Medicaid NJ
- Medicare (Including Railroad Medicare)
- Multiplan/PHCS
- QualCare
- Partners Direct Health
- Prime Health Services (PPO Provider Network)
- Stratose (NPPN)
- Three Rivers Provider Network
- Tricare (authorized non-network provider)
- UnitedHealthcare (Including Oxford, UHC Community Plan, Veterans Affairs CCN)
- US Family Health Plan (USFHP)
- Wellcare Health Plans of New Jersey
- Workers Comp
- Wellpoint (formerly known as Amerigroup Community Care)
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 you have insurance coverage from a company that is not listed above, the services are probably “out-of-network” and you will be responsible for a greater out-of-pocket expense.
For help selecting a plan that participates with Optum, please Contact us.
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.
- 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”.