Understanding your health insurance coverage is crucial, especially when choosing your healthcare provider. For those seeking care at Lexington Family Physicians, part of the Wake Forest Baptist Health system and associated with Lexington Medical Center (LMC), it’s important to know which insurance plans are accepted. Wake Forest Baptist Health is committed to working with a wide range of insurance providers to ensure patients have access to the care they need. This guide offers an overview of the health insurance plans generally accepted within the Wake Forest Baptist Health network, which includes Lexington Medical Center.
Understanding Insurance Acceptance at Lexington Family Physicians
Lexington Family Physicians, as part of the Wake Forest Baptist Health system, operates under a structure where physician services and hospital services are billed separately. This is a common practice within larger healthcare systems. It’s vital to remember that while many insurance plans are accepted, the specific coverage for services can vary. Therefore, simply seeing your insurance provider on a general list doesn’t guarantee full coverage for all services at Lexington Family Physicians or Lexington Medical Center.
Wake Forest Baptist Health has agreements with numerous insurance companies, including both local and national providers. The list provided below is a general guide to the most common health insurance plans accepted across the Wake Forest Baptist Health system as of April 2024. This includes services provided by physicians associated with Lexington Medical Center. However, due to the dynamic nature of healthcare contracts, this list is subject to change.
Key Insurance Providers Accepted
Wake Forest Baptist Health, including Lexington Medical Center and Lexington Family Physicians, generally accepts a broad spectrum of insurance plans. These include major national and regional providers:
- Aetna: Including Aetna Connected NC ACA/Exchange, Aetna NC Preferred+, Aetna (PPO & HMO), Aetna Medicare, and Aetna Whole Health.
- Alignment Healthcare Medicare Advantage
- Ambetter of NC
- AmeriHealth Caritas Next ACA/Exchange
- Blue Cross Blue Shield of North Carolina (BCBSNC): Encompassing BCBSNC (PPO & HMO), BCBS High Performance (National Network), Blue Local with Atrium Health, Blue Medicare, and Blue Value.
- Carolina Behavioral Health: (Please note specific location limitations as detailed in the original document).
- Cigna: Including Cigna, Cigna Behavioral Health, Cigna HealthSpring Medicare Advantage, and Cigna LifeSource (Transplants).
- Crescent PPO (Asheville): (Please note specific location limitations as detailed in the original document).
- Devoted Health (Medicare Advantage)
- Direct Net: (Please note specific location limitations as detailed in the original document).
- First Health Network: (Please note specific location limitations as detailed in the original document).
- FirstCarolinaCare (Pinehurst, NC): (Please note specific location limitations as detailed in the original document).
- Gateway Health Alliance (Virginia): (Please note specific location limitations as detailed in the original document).
- Healthgram (formerly Primary Physician Care): (Please note specific location limitations as detailed in the original document).
- HealthTeam Advantage
- Humana: Including Humana ChoiceCare and Humana Medicare Advantage.
- Liberty Advantage (Medicare Advantage): (Please note specific location limitations as detailed in the original document).
- Magellan (Behavioral Health): (Please note specific location limitations as detailed in the original document).
- MedCost and MedCost Ultra: (Please note specific location limitations for MedCost Ultra as detailed in the original document).
- PHCS/MultiPlan: (Please note specific location limitations as detailed in the original document).
- OptumHealth (Transplants – Applicable to NCBH/WFUHS Only): (Please note specific location limitations as detailed in the original document).
- Preferred Care of VA Inc: (Please note specific location limitations as detailed in the original document).
- Southern Health SVCS (Coventry-PPO Only): (Please note specific location limitations as detailed in the original document).
- Twin County (Virginia): (Please note specific location limitations as detailed in the original document).
- United Behavioral Health and United Behavioral Health Intensive Outpatient Program (WFUHS Only): (Please note specific location limitations as detailed in the original document).
- UnitedHealthcare: Including UnitedHealthcare, UnitedHealthcare Essentials ACA/Exchange, and UnitedHealthcare Medicare.
- VA CCN
- Wellcare (Medicare Advantage)
It is important to note the original document also lists specific contracts unique to Lexington Medical Center (LMC) to support Lexington employer groups under NATIONAL PROVIDER NETWORK/MEDICAL RESOURCES.
Important Considerations for Patients
While this list provides a helpful starting point, direct verification is always recommended. Here are key steps to ensure you have accurate information regarding your coverage at Lexington Family Physicians:
- Verify Your Specific Plan: Insurance plans can have numerous variations. Always check your individual insurance plan documents or online portal for the most accurate details about in-network providers and coverage specifics.
- Confirm Participation and Coverage: Even if your insurance provider is listed, confirm with your insurance company that your specific plan is accepted at Lexington Medical Center and by Lexington Family Physicians. Inquire about the coverage levels for the services you anticipate needing.
- Understand Separate Billing: Be aware that physician and hospital services are billed separately within the Wake Forest Baptist Health system. This may affect how your insurance processes claims.
- Contact Customer Service: If you do not see your plan listed or have any questions, reach out to Wake Forest Baptist Health’s Customer Service Center at 877-938-7497. They can provide the most up-to-date information and assist with any coverage inquiries.
Choosing Lexington Family Physicians for your healthcare needs means accessing quality medical professionals within a reputable system. By proactively verifying your insurance coverage, you can ensure a smoother and more informed healthcare experience. Always prioritize confirming your specific plan details to avoid unexpected costs and to fully utilize your insurance benefits at Lexington Family Physicians.
