Dr. Rainville and Dr. Matier participate with the following Insurance Companies:

They accept but are out of network providers for Qualcare.

Horizon Blue Cross Blue Shield

• Omnia Tier 1 (ONLY)
• Omnia Bronze
• Omnia Silver
• Omnia Silver HSA
• Omnia Platinum
• Omnia HAS
• Omnia Gold
• NJ Direct MA PPO
• NJ Direct
• Horizon Patient-Centered Adv EPO
• Horizon POS
• Horizon Medicare Blue Choice w/Rx (HMO)
• Horizon Medicare Blue Value (HMO)
• Horizon Medicare Blue Value w/Rx (HMO)
• Horizon MyWay HRA Direct Access
• Horizon MyWay HSA Direct Access
• Horizon Medicare Blue Choice w/Rx (HMO)
• Horizon Medicare Blue Value (HMO)
• Horizon Medicare Blue Value w/Rx (HMO)
• Horizon MyWay HRA Direct Access
• Horizon MyWay HSA Direct Access
• Horizon Medicare Blue Choice w/Rx (HMO)
• Horizon Medicare Blue Patient-Centered w/Rx (HMO)
• Horizon Medicare Blue Value (HMO)
• Horizon Medicare Blue Value w/Rx (HMO)
• Horizon MyWay HRA Direct Access
• Horizon MyWay HSA Direct Access

Cigna

• Open Access Plus, OA Plus ChoiceFund OA Plus
• Open Access Plus OA Plus, ChoiceFund OA Plus with CareLink
• PPO, Choice Fund PPO
• Network, HMO, POS

United Healthcare

• Choice
• Choice HMO
• Choice Plus
• Choice Plus with Harvard Pilgrim
• Choice with Harvard Pilgrim
• CORE
• CORE Essential
• CORE HMO/CORE Essential HMO
• Heritage Plus
• Heritage Select POS/HMO
• Heritage Select EPO
• Heritage Select Advantage – IA
• HERITAGE SELECT ADVANTAGE – AR, GA, NC, SC, TN
• NAVIGATE HMO / NAVIGATE BALANCED HMO / NAVIGATE PLUS HMO
• NAVIGATE / NAVIGATE BALANCED
• NAVIGATE PLUS
• NexusACO (Tier 1 Only)
• OPTIONS PPO
• OPTIONS PPO WITH HARVARD PILGRIM
• Select
• Select HMO
• Select Plus
• AARP MedicareComplete Essential (HMO) – Rainville Only at Clara Maass
• AARP MedicareComplete Plan 1 (HMO) – Rainville Only at Clara Maass
• AARP MedicareComplete Plan 2 (HMO) – Rainville Only at Clara Maass
• AARP MedicareComplete Plan 3 (HMO) – Rainville Only at Clara Maass
• AARP MedicareComplete Plan 4 (HMO) – Rainville Only at Clara Maass
• UnitedHealthcare Dual Complete ONE (HMO SNP) – Rainville Only at Clara Maass
• UnitedHealthcare Group Medicare Advantage (HMO) – Rainville Only at Clara Maass
• UnitedHealthcare Group Medicare Advantage (PPO) – Rainville Only at Clara Maass
• UnitedHealthcare Nursing Home Plan (HMO SNP) – Rainville Only at Clara Maass
• UnitedHealthcare Nursing Home Plan (PPO SNP) – Rainville Only at Clara Maass

AmeriHealth

• AmeriHealth Advantage (Tier 2)
• AmeriHealth Advantage Network for 2018 (Tier 2)
• Local Value Network
• Tier 1Advantage
• Tier 1 Advantage for 2018

Horizon NJ Health

• Horizon NJ Health
• Horizon NJ TotalCare (HMO SNP)

Aetna

• (CT) Aetna Whole Health – Hartford HealthCare & Value Care Alliance
• (ME) Aetna Whole Health℠- Maine – Aetna Select
• (ME) Aetna Whole Health℠- Maine – Health Network Only/Option
• (NC) Aetna Whole Health℠- Duke Health & WakeMed
• (NJ) Aetna Whole Health℠- Hackensack Meridian Health
• (NJ) Aetna Whole Health℠- Virtua
• (TN) Aetna Whole Health Tennessee
• (TX) PCP Referral Plan
• (VA) Aetna Whole Health℠- Coastal Virginia Health Partners
• (VA) Aetna Whole Health℠- VA Preferred – Roanoke
• NAP (National Advantage Plan)
• Aetna Choice® POS (Aetna HealthFund®)
• Aetna Choice® POS (Open Access)
• Aetna Choice® POS II (Aetna HealthFund®)
• Aetna Choice® POS II (Open Access)
• Aetna DC Bronze, Silver and Gold Open Access Health Network Only
• Aetna DC Bronze, Silver and Gold Open Access Managed Choice
• Aetna DC Silver and Gold PPO
• Aetna DE Bronze, Silver and Gold PPO
• Aetna DE Bronze, Silver and GoldOpen Access Health Network Option
• Aetna Health Network Only℠(Open Access)
• Aetna Health Network Option
• Aetna HealthFund® Aetna Health Network Only℠(Open Access)
• Aetna HealthFund® Aetna Health Network Option℠(Open Access)
• Aetna MD Bronze, Silver and Gold Open Access Health Network Only
• Aetna MD Bronze, Silver and Gold PPO
• Aetna Medicare℠Plan (HMO / Open Access HMO)
• Aetna Medicare℠Plan (PPO)
• Aetna Open Access® Elect Choice® EPO (Aetna HealthFund®)
• Aetna Open Access® Managed Choice® POS (Aetna HealthFund®)
• Aetna Premier Care Network Plus – Duke Health & WakeMed
• Aetna Premier Care Network Plus – Baptist Health System & Health Texas Medical (2017 providers)
• Aetna Premier Care Network Plus – Baptist Health System & Health Texas Medical
• Aetna Premier Care Network Plus – CHI Health Accountable Care Network (2017 providers)

• Aetna Premier Care Network Plus – CHI Health Accountable Care Network
• Aetna Premier Care Network Plus – INTEGRIS Health Partners Network
• Aetna Premier Care Network Plus – Maine
• Aetna Premier Care Network Plus – MemorialCare
• Aetna Premier Care Network Plus – Mercy Health Toledo
• Aetna Premier Care Network Plus – PinnacleHealth
• Aetna Premier Care Network Plus – Puget Sound
• Aetna Premier Care Network Plus – St. John Oklahoma Health Initiative
• Aetna Premier Care Network Plus – Texas Health
• Aetna Premier Care Network Plus – Virtua
• Aetna Premier Care Network Plus – WellSpan Provider Network
• Aetna Premier Care Network Plus-Banner Health Network
• Aetna Premier Care Network Plus-Banner Health Network
• Aetna Premier Care Network Plus-Baylor Scott & White Quality Alliance
• Aetna Premier Care Network Plus-Colorado Front Range
• Aetna Premier Care Network Plus-Colorado Front Range
• Aetna Premier Care Network Plus-Innovation Health
• Aetna Premier Care Network Plus-Innovation Health
• Aetna Premier Care Network Plus-Integris Network (2017 Providers)
• Aetna Premier Care Network Plus-Memorial Hermann Accountable Care Network
• Aetna Premier Care Network Plus-Memorial Hermann Accountable Care Network
• Aetna Premier Care Network Plus-Mercy Health Cincinnati
• Aetna Premier Care Network Plus-Mercy Health Cincinnati
• Aetna Premier Care Network Plus-Seton Health Alliance
• Aetna Premier Care Network Plus-Seton Health Alliance
• Aetna Select
• Aetna Value Performance Network℠(2015)
• Aetna Value Performance Network℠(2016)
• Aetna Voluntary Plans
• Banner Choice POS II Multi Tier
• Choice POS II
• Elect Choice® EPO (Open Access)
• Elect Choice® EPO
• HMO (Open Access)
• HMO / Health Network Only
• HMO
• Kansas Connector Elect Choice EPO
• Kansas Connector Managed Choice
• Kansas Connector Preferred Elect Choice EPO
• Kansas Connector Preferred Managed Choice
• Managed Choice Open Access/Managed Choice
• Managed Choice® (Open Access)
• Managed Choice® POS
• Mercy Preferred Aetna Choice POSII
• Mercy Preferred Aetna Select (Open Access)
• Mercy Preferred Elect Choice EPO (Open Access)
• Mercy Preferred Managed Choice (Open Access)
• Mercy Preferred Open Choice (PPO)
• Open Choice® PPO (Aetna HealthFund®)
• Open Choice® PPO
• PPO
• Peak Preference (Open Access) Aetna Select
• Peak Preference HNOnly (Open Access) on the Altius Network
• Peak Preference HNOption (Open Access) on the Altius Network
• QPOS®
• SW MO Region Premier Aetna Select (Open Access)
• SW MO Region Premier Elect Choice EPO (Open Access)
• Savings Plus of Amarillo, TX
• Savings Plus of Lake County, OH
• Savings Plus of Longview, TX
• Savings Plus of Massachusetts-OA Aetna Select
• Savings Plus of Massachusetts-OA Managed Choice
• Savings Plus of Massachusetts-POSII
• Savings Plus of Metro, NY
• Savings Plus of New Jersey Choice POS II
• Savings Plus of New Jersey-HMO/HNO
• Savings Plus of New Jersey-POSII
• Savings Plus of Ohio-POSII
• Savings Plus of Southeast Pennsylvania AFA-POSII
• Savings Plus of Southeast Pennsylvania Aetna Select Open Access
• Savings Plus of Southeast Pennsylvania Aetna Select
• Savings Plus of Southeast Pennsylvania Choice POS II
• Savings Plus of Southeast Pennsylvania HNOption/HMO/QPOS
• Savings Plus of Southeast Pennsylvania Managed Choice Open Access
• Savings Plus of Southeast Pennsylvania Managed Choice
• Savings Plus of Southeast Pennsylvania Open Choice PPO
• Savings Plus of Tennessee
• Utah Connected Network – Aetna Choice POS II (Open Access)
• Utah Connected Network – Aetna Select (Open Acess)
• Utah Connected Network – Aetna Select
• Utah Connected Network – Elect Choice EPO (Open Access)
• Utah Connected Network – Elect Choice EPO
• Utah Connected Network – Managed Choice POS (Open Access)
• Utah Connected Network – Managed Choice POS
• Utah Connected Network – Open Choice PPO
• Wesley Preferred Managed Choice (Open Access)

Magnacare

• Maritain Health (Must confirm Coverage for Bariatrix)
• Medicare
• OSCAR

Dr. Ballem and Dr. Gohil are In Network with all Horizon Cross Blue Shield products and in Tier 1

Horizon BCBS, Medicare, HMC Aetna, Qualcare, NJ Family Health (BCBS product), Barnabas Health insurance

HORIZON BLUE CROSS BLUE SHIELD

• Omnia Tier 1 (ONLY)
• Omnia Bronze
• Omnia Silver
• Omnia Silver HSA
• Omnia Platinum
• Omnia HAS
• Omnia Gold
• NJ Direct MA PPO
• NJ Direct
• Horizon Patient-Centered Adv EPO
• Horizon POS
• Horizon Medicare Blue Choice w/Rx (HMO)
• Horizon Medicare Blue Value (HMO)
• Horizon Medicare Blue Value w/Rx (HMO)
• Horizon MyWay HRA Direct Access
• Horizon MyWay HSA Direct Access
• Horizon Medicare Blue Choice w/Rx (HMO)
• Horizon Medicare Blue Value (HMO)
• Horizon Medicare Blue Value w/Rx (HMO)
• Horizon MyWay HRA Direct Access
• Horizon MyWay HSA Direct Access
• Horizon Medicare Blue Choice w/Rx (HMO)
• Horizon Medicare Blue Patient-Centered w/Rx (HMO)
• Horizon Medicare Blue Value (HMO)
• Horizon Medicare Blue Value w/Rx (HMO)
• Horizon MyWay HRA Direct Access
• Horizon MyWay HSA Direct Access

Please call our office to discuss a consultation and a full
analysis of your requirements: 800-633-8446