Orlando Harmon
CaroMont Health accepts a variety of insurance plans, including commercial health insurance, Medicaid, and Medicare. For individuals over 65 and eligible disabled individuals, CaroMont Regional Medical Center, CaroMont Specialty Surgery, and CaroMont Medical Group accept Medicare, Medicare Private Fee for Service, and Medicare supplemental insurance policies. It is important to note that insurance information is subject to change, and patients should verify their insurance coverage and confirm the participation of their hospital and physicians in their plans. Additionally, patients without insurance coverage or those who wish to file their own insurance claims must make full payment arrangements at the time of service.
| Characteristics | Values |
|---|---|
| Insurance Options | Commercial health insurance, Medicaid, Medicare |
| Medicare | Accepted for individuals 65+ years old and eligible disabled individuals |
| Medicare Private Fee for Service | Accepted |
| Medicare Supplemental Insurance Policies | Accepted |
| AARP Medicare | Hospital services covered as in-network for HMO members; PPO members use out-of-network benefits |
| United Medicare Advantage | Hospital services covered as in-network for HMO members; PPO members use out-of-network benefits |
| North and South Carolina Medicaid | Accepted |
| Molina Healthcare | Out of network for Absolute Total Care and Molina |
| Ambetter Care Plans | Not accepted |
| Payment Options for Uninsured Patients | Pay in full at the time of service or make satisfactory arrangements for payment |
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What You'll Learn
Medicare, Medicare Private Fee for Service and Medicare supplemental insurance policies
CaroMont Health, which includes CaroMont Regional Medical Center, CaroMont Specialty Surgery, CaroMont Endoscopy Center, Courtland Terrace, and CaroMont Medical Group, accepts Medicare, Medicare Private Fee for Service, and Medicare supplemental insurance policies for people 65+ years and eligible disabled individuals.
Medicare Private Fee-for-Service (PFFS) plans are a type of Medicare Advantage plan. PFFS plans are not the same as Original Medicare or Medigap. Under a PFFS plan, the plan determines how much it will pay doctors, other healthcare providers, and hospitals, and how much you must pay when you receive care. PFFS plans can offer full or partial networks of providers, or in some cases, they may not use a network of providers at all. Enrollees in PFFS plans can receive care from any hospital or doctor that accepts the plan's coverage, and they do not need a referral from a primary care doctor to see a specialist. However, reimbursements to doctors under a PFFS plan are not the same as under Original Medicare, and doctors can choose whether or not to accept the plan's patients.
CaroMont Health Facilities participate per the terms and conditions of Private Fee for Service Medicare plans. However, it is important to confirm upon registration and scheduling with your individual physician about their status of participation.
It is always recommended to contact your insurance company to verify your insurance coverage and confirm the availability of benefits. Additionally, you should confirm that the hospital, your physician, and any other health providers accept your insurance and participate in your plan.
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AARP Medicare
AARP also provides Medicare-related resources and information, including tips and updates to help manage healthcare costs, the latest news, educational tools, and events.
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United Medicare Advantage
UnitedHealthcare is the nation's leading provider of Medicare plans, offering a range of Medicare Advantage Part C plans. These plans offer all the benefits of Original Medicare (Part A and Part B), with additional extras such as dental, vision, hearing, and prescription drug coverage.
UnitedHealthcare offers four types of Medicare Advantage plans, which are designed to cater to a variety of budgets and healthcare needs. For instance, if you have diabetes, chronic heart failure, and/or cardiovascular disorders, you may qualify for a Chronic Special Needs plan (C-SNP). Additionally, Dual Special Needs plans (D-SNP) are Part C plans designed for those eligible for both Medicare and Medicaid coverage.
UnitedHealthcare also provides a range of member resources and programs to support your overall well-being. For example, eligible members can schedule yearly in-home health and wellness visits and work with a Care Navigator to receive additional support. There is also a mobile app that allows instant access to your prescriptions, pharmacies, plan benefits, and coverage.
UnitedHealthcare's Right Plan Promise® is a commitment to provide you with the tools and support to help find a suitable plan. However, it is important to note that enrollment in these plans depends on the plan's contract renewal with Medicare, and plan recommendations are based on the information you provide regarding your health coverage needs.
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Medicaid
Caremount Medical, which serves Hudson Valley, Westchester, Manhattan, and Bronx/Riverdale in New York, accepts a number of insurance plans. While the website does not explicitly mention Medicaid, it does state that Caremount Medical provides care for patients with traditional health insurance, managed care plans, Medicare, and for patients who pay out of their own pocket.
It is always best to contact the billing department of a medical provider to confirm whether your insurance is accepted. In the case of Caremount Medical, you can do this by calling 844-279-5734.
It is important to note that Medicaid is a federal and state health insurance program for eligible individuals with low incomes. Each state has its own set of rules and regulations for Medicaid, so the coverage and benefits can vary depending on where you live. Therefore, it is essential to check with your specific state's Medicaid program to understand the details of your coverage and which medical providers are considered in-network.
Additionally, it is worth mentioning that there are different types of Medicaid plans, such as managed care plans and fee-for-service plans, which offer different benefits and provider networks. Managed care plans typically contract with specific healthcare providers and require you to choose a primary care physician to coordinate your care. On the other hand, fee-for-service plans may offer more flexibility in choosing providers but may have different coverage rules and out-of-pocket costs.
By contacting Caremount Medical's billing department and your state's Medicaid program, you can ensure that you have accurate and up-to-date information about your coverage and in-network providers.
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Commercial health insurance plans
AARP Medicare
CaroMont Regional Medical Center, CaroMont Specialty Surgery, CaroMont Endoscopy Center, Courtland Terrace, and CaroMont Medical Group accept AARP Medicare. Hospital services are covered as in-network for HMO members, while PPO members use out-of-network benefits.
United Medicare Advantage
CaroMont Health facilities and physicians participate per the terms and conditions of Private Fee for Service Medicare plans. Hospital services are covered as in-network for HMO members, and PPO members use out-of-network benefits.
MultiPlan
CaroMont Health accepts MultiPlan insurance, but it is not specified whether this includes hospital services in Gaston County and CaroMont Medical Group physician services. Exclusions include "Practitioners Only" plans, "Practitioners and Ancillary Only" plans, and "Value-Driven Health Plans".
It is important to note that this information is subject to change. Patients are advised to contact their insurance company and CaroMont Health to verify coverage and confirm the participation of hospitals and physicians in their plans.
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Frequently asked questions
CareMount Medical (now Optum) serves Hudson Valley, Westchester, Manhattan, and Bronx/Riverdale in New York. I could not find specific information on the types of insurance they accept. However, they recommend that before obtaining services, you contact your insurance company to verify your insurance coverage and confirm the availability of benefits.
CaroMont Health Facilities accept North and South Carolina Medicaid. They also accept Medicare, Medicare Private Fee for Service, and Medicare supplemental insurance policies for individuals 65+ years old and eligible disabled individuals.
Ambetter Care Plans from Ambetter of North Carolina do not include CaroMont Health, so hospital services in Gaston County and CaroMont Medical Group physician services are not “in-network.”
