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Great news about lower premiums for Medicare: please read before making decisions: click here

 

Things to Consider When Shopping for Medicare Coverage

  • There are two main ways to get your Medicare coverage — Original Medicare and Medicare Advantage (Medicare-approved plans from private companies). There are differences between the two that are important to understand when choosing your coverage.

  • If you are selecting a Medicare Advantage plan, check with your health care providers to confirm they are in a plan’s network.  (We are not in-network for United Healthcare plans, AARP primary insurance, nor for HealthNet.)

  • If you are selecting a Medicare prescription drug plan, check if your prescriptions are included on a plan’s formulary.

  • Remember that a low monthly premium may not always be the best overall value to meet your specific needs.

  • Review a plan’s estimated total costs to you, including deductible and other out-of-pocket costs.

  • If you take insulin, there is a new out-of-pocket cap on a month’s supply of each insulin product when covered by a prescription drug plan or under Original Medicare. Talk to someone for help comparing plans by calling 1-800-MEDICARE.

The new Oregon Basic Health Plan will help insure low-income residents not eligible for Medicaid after the federal public health emergency ends.  click here 

Para garantizar que los habitantes de Oregón tengan acceso continuo a la atención médica, el estado planea establecer un Plan de salud básico para aquellos que perderán la cobertura del Plan de salud de Oregón.     click here

Be sure to check if  we will accept your insurance plan. YOU must call your insurance company and ask them.  Find out how much you will have to pay to see your rheumatologist (your co-pay).

    

We do not accept the plans listed below, if a primary insurance plan.

    (If you do not recognize these plans, you probably do not have one of these plans.)

  1. No HealthNet Ruby plans. We are out of network. We cannot see you.

  2. No Health Net Medicare Complement (HMO) plan. We cannot see you.

  3. No Primary Insurance UnitedHealthcare Commercial or Medicare. We are Out of Network Jan 1, 2023 will not accept primary plans from United Healthcare.  Check on your insurance card if your plan is managed by United Healthcare.  

  4. No AARP Medicare Advantage Plans (if it is your Primary Insurance).

  5. No UMR plans, if you have a plan that states you have no out-of-network benefit.

We will accept the Medicare Supplement plan/secondary insurance offered by AARP or UHC.

We will accept the plans listed below this notification. (Scroll way down.)

Your insurance choices will affect your treatment options. 

  • Investigate your insurance choices carefully.

  • Speak with the insurance company to verify if your physicians are 'in network'.

  • In order to be treated in our clinic, you may need a formal 'referral' from your primary care provider for many plans we accept. Please check with your insurance plan! 

  • Call your insurance company to verify approved treatments and coinsurance for your plan.

  • If you change insurance plans, you must inform us immediately as this could change treatments allowed by your new insurance, copays, and even if we are out of network.

 Health Insurance Basics: click here

 Common Insurance Mistakes: click here

 What does primary insurance mean? click here

Veterans' Insurance plans, Kaiser Permanente Plans are accepted with a PCP referral and authorizations. Please help us by being sure you have a referral/authorization in place.

 

Keep asking your insurance company questions!

Note on changing your Medicare Plans:  

If you are switching back to Traditional Medicare FROM a Medicare Advantage Plan, you will likely NOT be able to get your Medigap (Medicare Supplement) plan back, because you will have to go through underwriting (which means the plan will be very expensive, or you may not qualify for coverage at all). Beneficiaries are exempt from underwriting for Medigap supplement plans ONLY during their 1st 6 months of Medicare eligibility (and not at all if you initially choose a Medicare Advantage plan, because you can't have a supplement when you also have a Medicare Advantage plan).

This is what we call "Medicare Advantage's Dirty Little Secret". Most people, even those in healthcare, don't know these rules. PLEASE avoid a COSTLY mistake.

VETERAN'S INSURANCE: WE ACCEPT ALL VETERAN INSURANCES.​
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Current Insurance News

It is your responsibility to check your insurance. Please CALL the customer service number and ask, as their website provider lists are not always up to date

  • Bring all of your insurance cards to each visit, every time.

  • ALERT: You are financial responsible to us personally if you have not updated your insurance with us and your insurance does not pay us.

Are you thinking about changing insurance plans this year?

  • We advise you to contact a respected health insurance broker, or two, to discuss the impact of changing your health insurance at any time. Call our office to be certain BEFORE you change your plan

  • This will have tremendous impact on your access to treatments and your ability to pay your medical bills.

  • We also strongly suggest  a secondary insurance plan or a Medicare supplement plan to help pay your portion.

  • Please investigate thoroughly and carefully.

Here are several of the insurance companies we accept, in alphabetical order.

Forest Trees

AETNA

AETNA Plans: We are contracted with AETNA.

Click HERE for Managing Your HealthCare Costs on your Aetna Website for members.

CIGNA

Go to the website below to conveniently and privately access everything about your health plan. Click the video site tour for help on navigating the website.You can learn to check your coverage, get claim statuses, find account balances, search for a doctor, update your address and more.

Click below, and you will be directed to Cigna's website:

https://my.cigna.com/web/public/guest

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Health Net Plans

 We are 'out-of-network' for Health Net. Your payments to us will be higher. They will still pay us for your visit.

We do not accept Health Net's Medicare Advantage Plan THE RUBY PLAN

and  do not accept the Medicare Complement HMO Plans, and they will not pay us for your visit here.

Please check HERE at Health Net's patient center.

Jazz Festival Orange

Medicare Part B

We proudly accept Medicare.

Check your enrollment and more HERE.

Abstract Straight Lines

MODA/ODS

MODA Health Plan offers comprehensive and clear-cut health insurance policies.

Check with MODA customer services for understanding your financial responsibility. If you have questions about treatment plans, they are the best source for the most up to date information on what your plan covers.

Our rheumatologists accept patients with MODA coverage plans.

Click  HERE for myMODA for patients.

Misty Slopes

Pacific Source Health Plans

We accept patients that have medical coverage through PacificSource Health Plans.   Call them to verify your medical options for treatment and your financial responsibility

or you may  CLICK HERE  for online tools for members.

Mountain Lake

Providence Health Plan

Providence Health Plan is easy for us to contact. Your responsibility is to call them directly should you have any questions about payment or treatments.

We accept all Lane County plans and some state plans. Providence Health Plans, Providence Medicare Advantage Plans, PEBB, Providence Choice Plans and more. 

Click HERE for online tools for members.

Surfer Silhouette

Regence BCBS

We’ve developed a close relationship with the insurance representatives at Regence so we can help you handle any unforeseen difficulties that may arise.

Please take advantage of their skilled customer service reps for financial responsibility questions, billing or treatment questions.

Use their website HERE for a cost calculator and a member dashboard to track your deductibles; you can print a new insurance card.

Wild Horses in Black & White

Trillium Medicaid/Medicare

 Trillium Medicaid insurance: ACCEPTED.  

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United HealthCare News

 We will not abandon you as a patient.  

We do not give insurance plan advice.

  • NO UHC Commercial , if it is your primary insurance.

  • NO UHC Medicare Advantage plans—your primary Insurance

  • NO UMR plans

  • NO AARP Medicare Advantage plan—your primary insurance is affected.

         But the medicare supplement plan by AARP will not be affected.


View the UHC patient website for helpful tools and to view UHC links to find

other rheumatologists.
Information, links, tools and questions for patients on the website are created for you and your family.   www.myuhc.com

College Campus

University of Oregon Student Health Plan

Welcome U of O students! We will work with your U of O health insurance plan and other plans to provide you the best care during your time in Eugene.

If your insurance company is not on this list, please contact the insurance's customer support for your coverage questions.

The phone number is usually on your insurance card.

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