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New Health Insurance CardMedicare Advantage Plans

Open enrollment for Medicare begins in October each year. The vast majority of Medicare Advantage plans are HMOs or PPOs that require you to get your care from a specific local provider network.

It’s important to research your options carefully to ensure you receive the full benefits of your plan and care from the doctor and hospital of your choice.
 

Health Insurance Marketplace Open Enrollment

Open enrollment for the Health Insurance Exchange/Marketplace for coverage typically opens in November. When choosing a health plan, be sure visits to your physicians and hospital of choice are covered under the plan. Click here for more information.

Health Insurance We Accept

The following list is subject to change at any time. Please refer to your provider directory to ensure that Sarasota Memorial Health Care System is accepted by your insurance plan or contact your insurance company’s member services.In addition to the following list, Sarasota Memorial accepts:

Please note that we may not be in network with all plans for all payers. Please call your health plan for specific information. Except for the three plans listed above, Sarasota Memorial is an out-of- network provider for Medicare Replacement/Advantage HMO, PPO and POS plans. Except in emergency situations, using an out-of- network facility can result in a patient being responsible for a larger portion of a hospital bill.

We are not a network provider for Medicare Select supplemental plans. Medicare Select members may choose Sarasota Memorial for their care, but depending on each plan’s benefits, you may be responsible for the Part A deductible for non-emergency hospital care. Check with your insurance company, as some will pay that deductible when providers are not in network.

Aetna
4630 Woodland Corporate Blvd.
Tampa, FL 33614
Website
Aetna Signature Administrators
Commercial HMO
Commercial PPO
Exchange - QHP
International PPO
Medical Mutual of Ohio
Medicare Advantage HMO, PPO, and POS
Workers Compensation
(SMH does not accept the following plan types that may be administered by Aetna; Limited Benefit Plans, Short Term Medical Plans or discount cards.)

AmeriGroup (see Simply Healthcare)
P.O. Box 61010
Virginia Beach, VA 23466
Website
Medicaid HMO
Florida Healthy Kids

AvMed
9400 S. Dadeland Blvd.
Miami, FL 33156
Website
Commercial PPO
(all outpatient services require a pre-authorization)

Beacon Health Options (formerly Value Options)
240 Corporate Blvd.
Norfolk, VA 23502
Website
Behavioral Health

Blue Cross & Blue Shield of Florida (BCBS)
532 Riverside Ave.
Jacksonville, FL 32231
Website
Health Options HMO
Commercial NWB
Commercial PPO/PPC
Traditional PPO
Medicare HMO/PPO
Exchange - QHP: BlueOptions PPO, BlueCare HMO and myBlue HMO
BCBS BlueSelect: Sarasota Memorial and Blue Cross & Blue Shield (BCBS) of Florida are in a dispute regarding Sarasota Memorial’s participation status as to BlueSelect health plans. BCBS of Florida has taken the position that Sarasota Memorial Hospital is not a participating provider for members of its BlueSelect health plans. Sarasota Memorial disagrees.

(SMH does not participate in Blue Preferred Medicare HMO or Blue Preferred Medicare HMO SNP Alignment Healthcare Products.)

Cigna HealthCare of Florida
2701 North Rocky Point Dr.,
Suite 800
Tampa, FL 33607
Website
Commercial HMO
Commercial PPO
Exchange - QHP - Local Plus
NOTE: Our contract with Cigna is set to expire December 31, 2019. If we cannot reach a new agreement before that date, SMH will become out-of-network providers in Cigna’s commercial/employer group plans. For more information, click here.

Cigna Behavioral Health
11095 Viking Drive
Suite 350
Eden Prarie, MD 55344
Website
Behavioral Health

Compass Health Systems
(Behavioral Health)

1065 NE 125 St.,
Suite 206
Miami, FL 33161
Website
Behavoiral Health

Coventry Healthcare/First Health
6720-B Rockledge Dr.,
Suite 800
Bethesda, MD 20817
Website
Commercial HMO
Commercial POS
Commercial PPO
Workers Compensation

Gulf Coast Provider Network (GCPN)/Gulf Coast Provider Select
1991 Main St. #147
Sarasota, FL 34236
Website

Heritage/Summit Healthcare
P.O Box 988
Lakeland, FL 33802-0988
Workers’ Compensation
(All services require a pre-authorization.)
Website

Humana (See note below)
PO Box 14601
Lexington, KY 40512
Website
NOTE: Humana contract terminated March 31, 2019. For more information, click here. As of April 1, 2019, Sarasota Memorial is an out-of-network provider for Humana commercial/employer, Medicaid, Exchange & Medicare HMO & HMO/PPO.

Interplan Health Group (HealthSmart)
222 West Las Colinas Blvd
Suite 500N
Irving, TX 75039
Website
Commercial PPO
Workers Compensation

Magellan Behavioral Health
855 SW 78th Ave.
Plantation, FL 33324
Website
Summit Network
Pinnacle Network

Molina Healthcare (formerly Integral Health Plan)
8300 NW 33rd St.
Doral, FL 33122
Website
Medicaid HMO

Prestige Health Choice
P.O. Box 7367
London, KY 40742
Website
Medicaid HMO
Florida Healthy Kids
* Note: Prestige will no longer offer a Medicaid plan in our area after Jan. 1, 2019.

Red Card Payer Alliance (NON-PAR)
Red Card Payer Alliance Logo
(We do not accept any insurance with this logo on its card.)

Rockport Healthcare Group
50 Briar Hollow Ln. #515W
Houston, TX 77027
Workers Compensation
(Select locations)

Simply Healthcare (see AmeriGroup)
9250 West Flagler St.
Miami, FL 33174
Website
Clear Health Alliance Medicaid HMO
(We do not participate in the Better Health product)

Staywell WellCare
1323 W. Busch Blvd.
Tampa, FL 33612
Website
Children's Medical Services Health Plan
Medicaid HMO
Florida Healthy Kids
Serious Mental Illness

Sunshine State Health Plan
P.O. Box 3070
Farmington, MO 63640
Website
Child Welfare Specialty Plan
Medicaid HMO
(We do not participate in Ambetter products.)

TRICARE East Region
P.O. Box 8923
Madison, WI 53707-8923
Humana Military Website
Tri Care Website

United Behavioral Health (UHC/Optum)
11000 Optum Circle
Eden Prairie, MN 55344
Website
Behavioral Health

United Healthcare
9009 Corporate Lake Dr.
Tampa, FL 33634
Website
Commercial HMO
Commercial PPO
Exchange - QHP - Compass
Medicare HMO/PPO
(We do not participate in the Medicaid HMO product.)

USA Managed Care 
5301 Southwest Parkway
Suite 425
Austin, TX 78735
Website