MULTI-STEP COVERAGE CHECK
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1.
Patient Status
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Existing Patient
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2.
Insured Person & Coverage
Select Insurance Plan *
Select Insurance Plan
Select Insurance Plan
AAH Preferred – Team Member Plan
AAH Select – Team Member Plan
Aetna
Aetna Choice POS
Aetna Choice POS II
Aetna Elect Choice HMO (includes Aetna Health Funds)
Aetna EPO
Aetna Health Network Only
Aetna Health Network Option
AETNA HMO
Aetna Managed Choice (MC) POS
Aetna Managed Choice Open Access PPO
Aetna Medicare Explorer Value PPO
Aetna Medicare Open Access HMO
Aetna Medicare Open Access POS
Aetna Medicare Premier Plus PPO
Aetna Medicare Standard Plan EPO
Aetna Medicare Value Plan PPO
Aetna National Advantage Program (NAP) PPO
Aetna Open Access Aetna Select
Aetna Open Access Elect Choice (includes Aetna Health Funds)
Aetna Open Access HMO
Aetna Open Choice PPO
Aetna POS
AETNA PPO
Aetna QPOS
Aetna Select POS
Aetna Signature Authority (ASA or SRC) PPO
Ambetter Health
Blue Advantage HMO
Blue Advantage PPO
Blue Cross HMO Illinois
Blue Cross Medicare Advantage Basic HMO
Blue Cross Medicare Advantage Basic HMO – POS
Blue Cross Medicare Advantage Choice Plus PPO
Blue Cross Medicare Advantage Choice Premier PPO
Blue Cross Medicare Advantage PPO
Blue Cross PPO
Blue Medicare Advantage Premier Plus HMO-POS
Blue Precision HMO
BlueCare Direct
Cigna
Cigna Choice Fund EPO
Cigna Choice Fund OA Plus POS
Cigna Choice Fund PPO
Cigna HealthSpring Preferred
Cigna HealthSpring Premier
Cigna HealthSpring TrueChoice Medicare
CIGNA PPO
Coventry Health Care HMO
Coventry Health Care PPO
First Health Network EPO
First Health Network PPO
Health Alliance Employee EPO
HealthLink PPO
HFN EPO
HFN Platinum EPO
HFN PPO
HFN Total Care PPO
HST Care Connect EPO
Humana
Humana Choice POS
Humana Choice PPO
Humana ChoiceCare PPO
Humana Gold Choice PFFS
Humana Gold Plus HMO
Humana HMO
Humana Illinois CCN HMO
Humana National EPO
Humana National HMO
Humana National POS – Open Access
Humana National PPO
Humana Platinum HMO
Humana PPO
Humana Preferred POS – Open Access
Humana Preferred PPO
Humana Premier HMO
Humana Select HMO
Medicare Solutions PPO
Multiplan
Multiplan PPO
Oscar
PHCS PPO
SEIU – Local 4 HMO
SEIU – Local 4 PPO
Transportation Union Health and Welfare
UHC / AARP Medicare Advantage Walgreens
UHC / AARP Medicare Complete ACCESS HMO
UHC / AARP Medicare Complete HMO
UHC / AARP Medicare Complete Plan 1 HMO
UHC / AARP Medicare Complete Plan 2 HMO
UHC National Railway Carriers & United
UHC Railroad Employees National Health & Welfare Plan
UHC/ AARP Medicare Advantage Choice PPO
UniCare PPO
Union Medical (Local 1546) HMO
United Healthcare
United Healthcare Charter HMO
United Healthcare Choice Plus POS
United Healthcare Choice Select HMO
United Healthcare Core PPO
United Healthcare Group Retirees
United Healthcare HDHP Definity Basics PPO
United Healthcare Medicare Advantage
United Healthcare Medicare Complete Assure PPO
United Healthcare Navigate HMO
United Healthcare Navigate POS
United Healthcare NexusACO OA
United Healthcare NexusACO R
United Healthcare Options PPO
United Healthcare Select Plus POS
Other
Self-Pay
Please Specify Insurance Name *
Insured Person's First Name *
Insured Person's Last Name *
Insured Person's Email *
Insured Person's SMS/Texting Number *
Select Insured Person's Date of Birth *
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