USMD Hospital at Arlington receives Excellence in Prostate Cancer Surgery recognition

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Accepted Insurance Plans

The insurance benefits information provided to you by USMD Hospital at Arlington is for your hospital bill only. It is your responsibility to verify with any other providers and your insurance carrier whether your insurance plan will pay in-network or out-of-network benefits. USMD Hospital at Arlington admits and treats all patients regardless of race, creed, sex, national origin, age, or handicap.

Below is a list of some of the major insurance companies that have contracts with USMD Hospital at Arlington. Please contact our business office at 817-472-3400 to verify participation with your specific employer's health plan. Medicare patients should review this important information about non-covered tests and services.

USMD Managed Care Contracts

Access Direct

PPO

Aetna

CHIP, HMO, PPO, POS, Aetna Signature Administrators, Behavioral Health, Medicare Advantage PPO, Medicare Advantage HMO, Medicaid STAR HMO (Tarrant County Only), STARKids

Amerigroup

Medicare Advantage HMO, Medicare Medicaid Plan, Medicaid STAR HMO, STAR+PLUS, STARKids, CHIP

Beacon Health Strategies

Behavioral Health (Medicaid)

Beacon Health Options (formerly ValueOptions)

Behavioral Health (Commercial)

Blue Cross/Blue Shield

POS/PPO, HMO, Traditional, Blue Card, Medicare Advantage PPO, Medicare Advantage HMO, Medicaid, Behavioral Health

Blue Cross/Blue Shield (healthcare.gov)

Blue Cross Marketplace Plan (Health Care Exchange)

Care N’ Care

Medicare Advantage PPO, Medicare Advantage HMO

ChoiceCare

PPO, EPO

Cigna

PPO, HMO, Network/FLexcare, Open Access Plus (OAP), LocalPlus, Indemnity

Cigna Behavioral Health

Behavioral Health

Cigna HealthSpring, Inc.

Medicare Advantage PPO, Medicare Advantage HMO, Medicaid STAR+PLUS

City of Euless

Employer Group

City of Fort Worth

Employer Health Center Plan, Consumer Choice Plan

Cook Children’s Health Plan (CCHP)

CHIP, Medicaid STAR HMO, STARKids

Coventry Health Plan

PPO

Coventry Health Plan

PPO

DART

OAD w/HRA

First Health

PPO

Fort Worth Firefighters

Employer Group

Galaxy Health Network

PPO

HealthSmart

PPO, POS, GEPO, EPO, ACCEL

Humana

Medicare Advantage PPO, Medicare Advantage HMO

Humana Military Health

TRICARE – Military Medical

Humana Military Health/TRICARE Behavioral

TRICARE – Military Behavioral

Medicare

Molina Healthcare

CHIP RSA, Medicaid, STAR+PLUS, Medicare Advantage HMO-SNP, MMP

MultiPlan

PPO

Parkland Community Health Plan (CHP)

CHIP, STAR, Medicaid

PHCS

PPO

ProCare Advantage

Medicare Advantage I-SNP

QuikTrip

Employer Group

Superior HealthPlan

CHIP RSA, Foster Care, Medicaid STAR, Medicaid STAR+PLUS, Medicare Advantage HMO; MMP

United Behavioral Health

Behavioral Health

UnitedHealthcare

PPO, Options PPO, EOP, HMO, POS, Nexus ACO

UnitedHealthcare Medicaid

(Texas Health Stephenville ONLY)

UnitedHealthcare Benefits of Texas, Inc. (formerly Pacificare)

PPO, HMO, EPO

UnitedHealthcare Medicare Solutions (formerly Secure Horizons)

Medicare Advantage PPO, Medicare Advantage HMO

USA Managed Care

PPO

All patients should familiarize themselves with the terms of their insurance coverage. This will help you understand the hospital's billing procedures and charges.

What is medical necessity?

Original Medicare only covers tests/services it determines are reasonable and necessary for your care. We will tell you in writing if your doctor orders tests that Medicare may not pay for. However, you may not be told in writing if the test/service is already listed in your Medicare Handbook as a test that Medicare does not cover.

What services are not covered by Medicare?

Look in your Medicare Handbook for information on tests/services that are not covered by Medicare. If you choose to receive the tests/services, you will have to pay for tests/services that are not covered and for tests/services that Medicare feels are not needed for your care.

What is an ABN?

An ABN is an Advance Beneficiary Notice form. The ABN form tells you in advance that Medicare may not pay for your test/service. This form tells you which tests Medicare may decide are not reasonable and necessary for your care and tells you that you will have to pay for those services. When we give you the form, you will be asked to sign it before the tests/services are done.

What options do I have?

You have three options when an ABN form is given to you: (1) agree to pay for the tests/services that Medicare may not cover. The hospital will still bill Medicare and you will be responsible for payment if Medicare denies payment; (2) agree to pay for the tests/services that Medicare may not cover and the hospital does not bill Medicare; or (3) not get them done. If you meet the hospital's charity care rules, you may ask for help in paying for the test/service.

What are my rights as a patient?

As a Medicare patient, you have rights. These rights protect you and help see that you get needed health care tests/services. Your rights include:

  • The right to information on what tests are covered and how much you will have to pay.
  • The right to information on your treatment options.
  • The right to appeal Medicare decisions.
  • The right to ask for help under the hospital's charity care program.

How does billing work?

Your doctor will bill Medicare when you get tests in his or her office. But when your doctor orders tests from someone outside of his or her office, that person or facility bills Medicare for the test.

If Medicare will not pay for a test/service, does that mean I do not need it?

No. Your doctor decides what tests/services you need based on a wide range of factors like your prior medical care, and drugs you might be taking. Even if your doctor feels a test/service is "good medicine," Medicare may not consider it to be medically necessary for patients with your diagnosis. When this happens, Medicare will not pay for the test/service; we will ask you to sign an ABN form, and will bill you for the test.

USMD Hospital at Arlington is a joint venture with Texas Health Resources and meets the definition under federal law of a physician-owned hospital. Doctors on the medical staff practice independently and are not employees or agents of the hospital. A list of physician owners is available upon request.