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Participating Insurance Plans

As of August 27, 2014, Johns Hopkins Community Physicians is contracted with the insurance plans listed below.

This list is not all-inclusive, updated periodically and subject to change. Please contact your health plan to verify participation and coverage prior to scheduling your appointment.

Important Points to Consider:

  1. Insurance contracts for Johns Hopkins Community Physicians may vary from insurance contracts for other Johns Hopkins entities.
  2. Johns Hopkins Community Physicians is contracted to participate with insurance plans and provider networks that offer both primary and specialty care benefits.
    • Primary Care: If your plan requires the selection of a primary care provider (PCP), you must select a Johns Hopkins Community Physicians PCP to be covered for primary care services.
    • Specialty Care: Your managed care plan may require you to obtain a referral from your PCP in order to receive coverage for services provided by a Johns Hopkins Community Physicians specialist.
  3. There may be certain medical services provided by our practitioners that are not covered by our contract with your health plan. Some contracts carve-out laboratory services, radiology and other ancillary services.
  4. Certain plans (including some plans offered through the Health Benefit Exchange markets) may limit the geographic area in which you are able to receive care; even for routine services. Your insurer may refer to this as a “LIMITED NETWORK” plan.
  5. Johns Hopkins Community Physicians is participating with Medicare but IS NOT participating with Medicare Advantage Plans. (Limited Participation Only for some Johns Hopkins Community Physicians cardiologists.)
  6. Johns Hopkins Community Physicians is participating with Maryland Medical Assistance but IS NOT participating with Out-of-State Medical Assistance plans.
  7. Johns Hopkins Community Physicians providers practicing at locations within the District of Columbia are participating with District of Columbia Medical Assistance.

Insurance Plans

A

Aetna

  • Aetna Advantage Plan
  • Aetna Choice POS
  • Aetna Choice POS II
  • Aetna Elect Choice*
  • Aetna HMO*
  • Aetna Health Network Only
  • Aetna Health Network Option
  • Aetna Innovation Health
  • Aetna Limited Benefits Insurance Plan
  • Aetna Managed Choice*
  • Aetna Medicare HMO/PPO
  • Aetna Meritain Health
  • Aetna Open Choice PPO
  • Aetna Quality POS
  • Aetna Select*
  • Aetna Signature Administrators
  • Aetna Student Health Plan

    *Includes all Open Access plans

B

Beech Street PPO
Berkshire Health Partnership - PPHN
Blue Cross Blue Shield (BCBS)

  • BCBS National Accounts
    • Product types and plan requirements vary. Contact your insurance plan to confirm that your provider is participating with your specific product/plan.
  • BCBS Federal Basic
  • BCBS Federal Standard

C

CareFirst

  • CareFirst Administrators
  • CareFirst BlueChoice Advantage
  • CareFirst BlueChoice HMO**
  • CareFirst BlueChoice Opt-Out*
  • CareFirst BlueChoice Triple Options/Triple Choice
  • CareFirst BlueChoice HealthyBlue*
  • CareFirst BlueChoice HealthyBlue Advantage
  • CareFirst BlueChoice HealthyBlue 2.0*
  • CareFirst BCBS POS
  • CareFirst BCBS PPO
  • CareFirst NCAS
    • Access to providers participating in the CareFirst PPO/PPN Network only
  • CareFirst Third Party Administrator (TPA)
  • Access to providers participating in the CareFirst PPO/PPN Network only and CareFirst BlueChoice Network only

    *Includes all Open Access plans

Central Susquehanna Healthcare Provider, Inc. PPHN
Cigna

  • Cigna Choice Fund
  • Cigna – Great West Healthcare
  • Cigna HMO Mid-Atlantic (District of Columbia, Maryland and Virginia)*
  • Cigna Open Access Plus
  • Cigna Open Access Plus In-Network
  • Cigna POS Mid-Atlantic (District of Columbia, Maryland and Virginia)*
  • Cigna PPO

    *Includes all Open Access plans

Conifer – Community Health Partners (CHP)
Coventry Health Care

  • Coventry Health Care CARELINK PPO
  • Coventry Health Care of Delaware HMO
  • Coventry Health Care of Delaware Open Access Plus
  • Coventry Health Care of Delaware PPO
  • Coventry Health National Network
  • Coventry One
  • Coventry Health Care of Virginia PPO
  • Health America PPO

D


E

Employer Health Programs (EHP)
Evergreen

  • Evergreen Health Care HMO
  • Evergreen Health Insurance POS

F

First Health


G


H

HealthSmart ACCEL Network
Humana Choice Care Network


I


J


K

Kaiser Permanente of the Mid-Atlantic

  • Kaiser Permanente Added Choice
  • Kaiser Permanente Flexible Choice
  • Kaiser Permanente Medicare Cost Plan (Specialty Care Only)
  • Kaiser Permanente Self-Funded Plans (EPO, POS, PPO)
  • Kaiser Permanente Select
    • Kaiser Permanente Select provides coverage for primary care at designated Johns Hopkins Community Physicians primary care sites. Kaiser Added Choice,  Flexible Choice and Point-of-Service plans provide an out-of-network benefit for primary care at any Johns Hopkins Community Physicians primary care site.
  • Kaiser Permanente Signature (Specialty Care Only)

L


M

Medicaid (Traditional)

  • District of Columbia Medical Assistance
    • Limited primary and specialty care participation for Johns Hopkins Community Physicians District of Columbia locations
  • Maryland Medical Assistance

Medicare

  • Medicare Part B
  • Medicare Advantage & Cost Plans
    • Johns Hopkins Community Physicians typically does not participate with Medicare Advantage plans. For limited plan exceptions, see Aetna Medicare and Kaiser Medicare Cost Plan.
  • For all other plans, the following applies:
    • Out-Of-Network Benifits Only: If your Medicare Advantage plan offers out-of-network benefits and you choose to use them, you will be responsible for any additional and/or higher out-of-pocket costs including copays, deductibles and co-insurance amounts.

MultiPlan


N


O


P

Preferred Health Care PPHN
Priority Partners
Private Healthcare Systems


Q


R


S

South Central Preferred


T

The Preferred Healthcare System, Inc.
TRICARE HealthNet Federal Services

  • TRICARE Prime (North Region - Specialty Care Only)
  • TRICARE Standard/Extra
  • TRICARE Young Adult Extra
  • TRICARE Young Adult Prime (North Region - Specialty Care Only)

TRICARE USFHP

  • Johns Hopkins US Family Health Plan (USFHP) TRICARE Prime

Tyoga CareNet PPG PPHN


U

UnitedHealthcare

  • M.D. IPA
  • M.D. IPA Preferred
  • OneNet PPO
  • Optimum Choice
  • Optimum Choice Preferred
  • UnitedHealthcare Choice
  • UnitedHealthcare Choice Plus
  • UnitedHealthcare Options PPO
  • UnitedHealthcare Shared Services
    • Access to providers participating in the UnitedHealthcare Choice/Choice Plus and Options PPO Networks
  • UnitedHealthcare Select Plus POS
  • UnitedHealthOne
    • Access to providers participating in the UnitedHealthcare Choice Plus Network
  • United Medical Resource (UMR)
    • Access to providers participating in the UnitedHealthcare Choice/Choice Plus and Options PPO Networks
       

V


W


X


Y


Z


Non-contracted Insurance Plans

Johns Hopkins Community Physicians also accepts the following non-contracted insurance plans:

  • American Association of Retired Persons (AARP)
  • BCBS Out-of-Area
    • Product types and plan requirements vary. Some out-of-area plans include limitations on care that can be received outside of the member’s home state. Contact your insurance plan to confirm that your provider is participating with your specific product/plan.
  • TRICARE Continued Health Care Benefits Program
  • TRICARE for Life  
  • TRICARE Standard (South and West Regions)

If the name of your insurance plan is not listed as a participating contracted plan or a non-contracted plan that we accept, contact your insurer to verify participation. You may also direct general questions regarding participation to the Office of Managed Care at 410-762-5954.

 
 
 
 
 
 

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