Insurance Plans Accepted by Emory Healthcare

Accepted Commercial Insurance

Aetna HMO
Aetna POS
Aetna PPO
Aetna Whole Health
BCBS HMO
BCBS POS
BCBS PPO
BCBS HPN (Blue Connection)
BCBS PAR (indemnity plans)
Beech Street
Cigna Health Plans (excluding Cigna
Local Plus and
Cigna Connect Plans) - see footnote
Cigna + Oscar Open Access (excluding Cigna
+ Oscar LocalPlus) - see footnote

CorVel PPO
Crescent Health Solutions
FirstHealth PPO (formerly a Coventry Product)
Galaxy Health Network
Humana HMO
Humana POS
Humana PPO
Kaiser EPO Self-Funded Plans – see footnote
Kaiser Permanente Added & Multi-Choice - see footnote
Kaiser Permanente Dual Choice PPO
Kaiser Permanente HMO Health Plans - see footnote
LifeWell Health Partners
Memorial Health Services

MultiPlan
Northeast Georgia Health Partners
NovaNet
Optum (VA Beneficiaries only)
Private Health Care Systems (PHCS)
State Health Benefit Plan
Tricare Prime
Tricare Select
Tricare Prime Option Plan
United Healthcare (All Commercial Plans)
United Healthcare Narrow Network Plans: Core and Charter - see footnote
United Healthcare Tiered Network Plans: Nexus - see footnote
USA Managed Care Organization

Commercial Insurance Plans - Additional Plan Information:

For Cigna: All of Emory Healthcare participates with most Cigna Health Plans including Cigna + Oscar Open Access plans. However, for the following plans, Cigna LocalPlus, Cigna Connect, and Cigna + Oscar LocalPlus, Emory Healthcare only participates for Behavioral Health services and services provided by EMCF at Grady Hospital and Grady outpatient clinics.

For Kaiser health plans: Referral and authorization provisions apply. Please contact your primary care physician’s office or member services phone number located on the back of your insurance card for more information.

For United Healthcare Narrow Network Plans and Tiered Network Plans: There are select counties where Emory is the top Tiered Provider. Please contact your primary care physician’s office or member services phone number located on the back of your insurance card for more information.

Accepted Exchange Insurance Plans

Aetna CVS Plans (Georgia Members only) - see footnote
Ambetter by Peach State Health Plan: Bronze, Silver, and Gold (excluding Ambetter Select plans)
Anthem Silver Blue Value X - starting 1/1/25 - see footnote
Blue Value Individual Network HMO - starting 1/1/25 - see footnote
BCBS Anthem Pathway Health Plans

BCBS Pathway Guided Access and Enhanced Plans
BCBS Pathway HMO Plans
Kaiser Exchange Options (all plans) - see footnote
Oscar Health Plan of Georgia: Gold, Silver, Bronze

Accepted Exchange Insurance Plans - Additional Plan Information:

Aetna CVS Plans – Emory Healthcare is only in-network for Georgia members. All non-Georgia members from other states are considered out-of-network.

Anthem Silver Blue Value X and Blue Value Individual Network HMO Plans: For 2024, EHC is out-of-network. Members should contact their plans for in-network providers. However, starting 1/1/25, EHC will be an in-network provider for these plans. EHC will remain in-network for 2024 and 2025 for all other Anthem Exchange Plans, including Anthem’s Pathway and Pathway X plans.

For Kaiser health plans: Referral and authorization provisions apply. Please contact your primary care physician’s office or member services phone number located on the back of your insurance card for more information.

NOT Accepted Exchange Insurance Plans

X

NOT Accepted Insurance Plans - Additional Plan Information:

Anthem Silver Blue Value X and Blue Value Individual Network HMO Plans: For 2024, EHC is out-of-network. Members should contact their plans for in-network providers. However, starting 1/1/25, EHC will be an in-network provider for these plans. EHC will remain in-network for 2024 and 2025 for all other Anthem Exchange Plans, including Anthem’s Pathway and Pathway X plans.

For Cigna: All of Emory Healthcare participates with most Cigna Health Plans including Cigna + Oscar Open Access plans. However, for the following plans, Cigna LocalPlus, Cigna Connect, and Cigna + Oscar LocalPlus, Emory Healthcare only participates for Behavioral Health services and services provided by EMCF at Grady Hospital and at Grady outpatient clinics.

Accepted Medicare Advantage Insurance Plans

Traditional Medicare Part A & Part B
Aetna Medicare Advantage HMO
Aetna Medicare Advantage PPO
BCBS Medicare Advantage HMO
BCBS Medicare Advantage PPO
Cigna HealthSpring Medicare Advantage HMO & PPO
Clover Health Choice PPO
Clover Health Choice Value PPO

Clover LiveHealthy PPO (Walmart)
Devoted Medicare Advantage
Clear Springs Health Medicare Advantage Plans (HMO and PPO) – EMCF at Grady only - see footnote
Humana Gold Plus Medicare Advantage HMO
Humana Medicare Advantage D-SNP Plans
Humana Gold Choice Medicare Advantage PPO
Kaiser Medicare Advantage - see footnote

Sonder Complete Health HMO
Sonder Diabetes Wellness HMO (C-SNP)
Sonder Dual Complete
Sonder Heart Healthy HMO (C-SNP)
WellCare Medicare Advantage HMO
WellCare Medicare Advantage PPO
United Healthcare Medicare Advantage Plans - see footnote

Medicare Advantage - Additional Plan Information:

For Clear Springs Health Medicare Advantage Plans: Emory Healthcare only participates for services provided by EMCF at Grady Hospital and at Grady outpatient clinics. All other EHC providers and facilities are not participating.

For United Healthcare Medicare Advantage health plans: Emory Healthcare participates with all plan types except for the following: Private Fee-For-Service Benefit Plans and Medicare Advantage Medical Savings Account Benefit Plans.

For United Healthcare Narrow Network Plans and Tiered Network Plans: There are select counties where Emory is the top Tiered Provider. Please contact your primary care physician’s office or member services phone number located on the back of your insurance card for more information.

For Kaiser health plans: Referral and authorization provisions apply. Please contact your primary care physician’s office or member services phone number located on the back of your insurance card for more information.

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