Medical Insurance

 

Special Note for Medicare Advantage BlueMedicare HMO patients: Effective January 1, 2017, at the request of Florida Blue, Watson Clinic LLP primary care physicians will no longer be in network for the HMO product ONLY. All of your remaining specialists will remain in network and must have a referral from your new PCP to continue your care. Florida Blue will reassign you to the care of a new, in-network primary care provider of their choosing. They will be sending you a letter shortly with this updated information.

Please be advised this was the sole decision of Florida Blue. Watson Clinic diligently attempted to prevent this change and we were regrettably unable to do so.

 

Watson Clinic accepts Medicare assignment of benefits for traditional and supplemental Medicare along with many Medicare Advantage plans. The clinic is also contracted with most commercial medical insurance plans including HMO’s and PPO’s.

Below is a list of currently contracted and accepted insurance plans. If you have insurance that is contracted with Watson Clinic, you are responsible for all applicable copays, co-insurance, deductibles and costs for any non-covered services you receive on the day of service. Please understand that we cannot waive patient balances.

Your insurer may be making changes to your coverage in 2018. Please contact them to verify our participation with your plan.


Participating Insurance Plans

Medicare & Medicare Advantage Plans

Traditional Medicare

All Medicare Supplemental Plans (commonly called "secondary plans")

The following Medicare Advantage Plans:

  AARP Medicare Advantage Plans through UnitedHealthcare
  • AARP MedicareComplete HMO
  • AARP MedicareComplete Choice PPO
  • AARP MedicareComplete Choice Essential Regional PPO
  • AARP MedicareComplete Choice Plan 2 Regional PPO
*Non-Contracted: WellMed Delegation HMO (specialist visit only, referral required)
  Aetna Medicare Advantage Plans
  • Aetna Medicare Choice Plan HMO - POS
  • Aetna Medicare Premier Plan PPO 
  • Coventry Medicare Summit (specialist visit only, referral required)     
  Florida Blue Medicare Advantage Plans
  • BlueMedicare Choice Regional PPO
  • BlueMedicare Classic HMO - Specialists Only
  • BlueMedicare Classic Plus HMO - Specialists Only    
   Humana Medicare Advantage Plans
  • Humana Gold Choice Florida PPO
  • Humana Choice PPO
  • Humana Gold Plus HMO (specialist visit only, referral required)

Medicare Advantage Special Needs Plans


  Florida Blue Medicare Advantage Special Needs Plans
  • BlueMedicare Complete HMO SNP -Specialist Only
   UnitedHealthcare Medicare Special Needs Plans
  • UnitedHealthcare Assisted Living Plan PPO SNP
  • UnitedHealthcare Dual Complete LP HMO SNP 
  • UnitedHealthcare Dual Complete RP Regional PPO SNP
  • UnitedHealthcare Dual Complete RP ONE Regional PPO SNP
  • UnitedHealthcare Nursing Home Plan PPO SNP  
*Non-Contracted: WellMed Delegation HMO (specialist visits only, referral required)

Commercial Insurance

Aetna – all plans except those sold through the public exchanges/marketplaces

AvMed – all plans except for Individual and Engage Plans
  • Optometry and routine vision care are not available for AvMed members at Watson Clinic

Beechstreet – all plans

Cigna/GWH-Cigna – all plans
  • Cigna BayCare Choice is contracted with specific providers
  • Florida Hospital employees use tier 2 benefits with higher out-of-pocket costs

Coventry National Network including First Health - except Workers Compensation, Coventry of Florida and Medicare plans

Evolutions Healthcare System - all plans

MedSave USA, Inc. - all plans

Florida Blue – all plans except BlueSelect, FamilyBlue, Miami-Dade Blue, MyBasic Blue Select. Blue Cross Blue Shield Blue Select from North Carolina is accepted.

Humana - most plans

  • Humana HMO plans do not cover Podiatry services at Watson Clinic

Multiplan – all plans

Private Healthcare Systems – all plans

Tricare Prime
  • Authorization required for full benefits otherwise member will have to utilize their out-of-network benefits at a higher out-of-pocket expense. Watson cannot be PCP. 
Tricare Standard

Watson Clinic does not accept Medical Discount Cards of any kind.
 
What if I have an out-of-network plan or no insurance? 
If you have an insurance plan that Watson Clinic does not contract with (commonly referred to as an "out-of-network" plan) or do not have insurance, you will be responsible for payment of all charges on the day of service. Our financial counselors are available to assist you in making alternative payment arrangements if necessary. Please understand that we cannot waive patient balances.
 
Click here for a printable version.
If you have further questions, please contact Patient Relations at 863-680-7206. 

Information about the Affordable Care Act & You!

Healthcare reform took full effect in January 2014, and there are new ways to buy health insurance called the Health Insurance Marketplace. Americans will be required to have healthcare coverage or pay a penalty. The Government has established a website bringing together information about all of your options in one online location. For those without employer-provided insurance or Medicare/Medicaid, this will allow you an opportunity to compare your choices, learn if you're eligible for public health insurance programs or tax credits that will make coverage more affordable, and join the plan of your choosing.

When you’re shopping for yourself, your family, or a small business, you can enroll in an exchange during the annual open enrollment period of November 1, 2018 to January 21, 2018. Here’s how you do it:

  • Visit healthcare.gov and create a free account.
  • Enter the information requested including income, household size, etc.
  • The system uses this information to produce a list of coverage options that are open to you. You’ll also be given additional options for lower cost premiums, or possible financial assistance, if you qualify. 
  • Enroll in the plan of your choice.                  

An important note: Make sure you confirm the insurance plans Watson Clinic accepts before you purchase coverage. Many times, consumers are misinformed as to which plans are honored by our Clinic physicians, so please review the information listed above.


Important news for our Medicare patients

All patients with Medicare are eligible to participate in the following programs offered at no charge by Watson Clinic.

Welcome to Medicare Visit
Recently enlisted Medicare beneficiaries are eligible to receive a free Welcome to Medicare preventive health evaluation (also known as the Initial Preventive Physical Examination or IPPE) within the first 12 months of their enrollment. This one-time only visit focuses exclusively on health promotion and disease detection, and serves as a great primer on your road to continued wellness and productivity.

The IPPE includes:

  • Assessment of vital signs
  • General vision test
  • Discussion on the importance of drafting advance directives
  • Review of potential health risk factors
  • Recommended list of screenings, immunizations, and additional services prepared just for you!

Medicare Annual Wellness Visit
After 12 months of enrollment or one year after your Welcome to Medicare Visit, Medicare beneficiaries receive full coverage for an Annual Wellness Visit. During this examination, we will update your medical record with all pertinent information from the past year, review your history and risk factors for disease, ensure that your medication list is up to date, and provide personalized health advice and counseling.

Click here to see our Medicare Annual Wellness Visit brochure.
 
Important Note: Medicare provides coverage of the AWV and the IPPE as Medicare Part B benefits. (There is no coinsurance, copayment or Medicare Part B deductible for these benefits.)