Insurances Accepted & Billing

At Houston Thyroid and Endocrine, we have competitive cash rates for our uninsured patients and out-of-network patients. The patient is responsible for knowing what is covered as a copay or deductible and ensuring proper insurance coverage.

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List of Insurances for which we are In-Network

We are not contracted with MyBlueHealth, which begins with alpha prefix: T2G in the member ID number.

Insurance Contracts are always changing, if you have any questions, please contact the office for specific instances.

Aetna Commercial/Whole Health (no "QHP" marketplace plans)

Blue Cross Blue Shield Essentials/Health Select/Premier HMO (Referral may be required through insurance)

Blue Cross Blue Shield HMO/POS

Blue Cross Blue Shield PPO/Blue Choice

Blue Cross Blue Shield HMO

Blue Cross Blue Shield PPO

Blue Cross Blue Shield Medicare Advantage PPO

Blue Cross Blue Shield Medicare Advantage HMO (Referral required through insurance)

Cigna Commercial

Cigna Local Plus

Cigna Surefit

CHAMPVA

Community Health Choice Marketplace only

First Health Insurance

Freedom Life Insurance (Televisits not covered)

Friday Health Plans

GEHA

Great West- Cigna

Group & Pension Administrators

HC Hwys Logix/Sync (including MNA Neuro)

Medicare***

Methodist hospital system employees

Memorial Hermann HMO

Memorial Hermann Care/Catastrophic

Memorial Hermann Select HMO/PPO

Memorial Hermann Walmart (Including MNA Neuro.)

Multiplan PPO

Oscar Health

Palmetto GBA (Railroad Medicare Insurance)

PHCS PPO

Tricare Standard (not Prime)

UMR

United Healthcare PPO (no "QHP" marketplace plans, no charter plans )

United Healthcare Commerical Products

Walmart Memorial Hermann Accountable Care Plan

What is a co-pay and what is a deductible? They both involve payment on the part of the insured, but the amount and frequency differ.

KEY TAKEAWAYS

  • Co-pays and deductibles are both features of most insurance plans.

  • A deductible is an amount that must be paid for covered healthcare services before insurance begins paying.

  • Co-pays are typically charged after a deductible has already been met. In some cases, though, co-pays are applied immediately.

  • Some plans have a separate deductible for prescription drugs or other services. With family plans, there are often two deductibles: for an individual, and for the whole family.


WHAT IS A COPAY?

A co-pay, short for co-payment, is a fixed amount that a healthcare beneficiary pays for covered medical services. The remaining balance is covered by the person’s insurance company.

Co-pays typically vary for different services within the same plans, particularly when they involve services that are considered essential or routine and others that are considered less routine or in the domain of a specialist.

Co-pays are typically lower for standard doctor visits than for seeing specialists. Co-pays for emergency room visits tend to be the highest.

WHAT IS A DEDUCTIBLE?

A deductible is a fixed amount that a patient must pay each year before their health insurance benefits begin to cover the costs.

After meeting a deductible, beneficiaries typically pay co-pay - a certain percentage of costs—for any services covered by the plan. They continue to pay the co-insurance until they meet their out-pocket maximum for the year.

IS A COPAY SAME AS DEDUCTIBLE?

No, but the two terms are often confused.

A co-pay is a fee that you pay when you receive healthcare services, such as visiting a doctor or picking up prescriptions. Your health insurance company will pay part of this cost, and you will pay the rest. A deductible is a set amount that you must meet for healthcare benefits before your health insurance company starts to pay for your care. Co-pays are typically charged after a deductible has already been met. In most cases, though, co-pays are applied immediately.

WHAT IS AVERAGE COPAY AND DEDUCTIBLE?

This will depend on your personal circumstances, but a high-deductible plan is generally regarded as any plan that has a deductible of $1,400 or more for an individual or $2,800 or more for family coverage. Plans with lower deductibles will have higher monthly premium costs.

Though high-deductible plans usually cost you more in out-of-pocket expenses, they can have advantages that offset that cost. Generally, high-deductible plans qualify for a Health Savings Account, which can help you to save for and manage healthcare costs.



As of 4/21/2017 we no longer accept BCBS HMO Blue Advantage.

If you would like to be a patient of our practice but do not have medical insurance we have reasonable rates which you can request via phone. If we do not participate with your insurance carrier our charges will apply as out-of-network coverage.

*** We are not enrolled with Medicaid and therefore cannot see any ADULT medicaid patients.

^By law we cannot accept Adult patients that have Medicaid as a primary or secondary insurance.

^^ We are in-network with all Aetna products except for those with the mark "QHP" (Marketplace/Health Exchange/Obamacare) on the insurance card

^^^ We are in-network with all United products except for those obtained via Marketplace/Health Exchange/Obamacare

&& We are not enrolled with BCBS HealthSelect of Texas (Group number 038000), and we do accept BCBS Blue Advantage

Updated 11-6-2018