Yale doctors and providers participate in most managed care plans in our region. The plans in which we participate are listed alphabetically by company name.
Most YMG providers participate with all of the contracted managed care carriers listed below, however there are some exceptions, which are listed at the bottom of this page.
| Commercial, HMO & PPO |
Referral
Required
to see
Specialist |
Member
Eligibility |
Pre Certification
and Referrals |
Aetna/US Healthcare www.aetna.com |
| Aetna Health Fund |
NO |
Call # on ID Card |
Call # on ID Card |
| Aetna Select |
YES |
888-632-3862 |
888-632-3862 #3 |
| Choice POS |
NO |
800-624-0756 |
800-624-0756 #3 |
| Choice POS II |
NO |
888-632-3862 |
888-632-3862 #3 |
| Elect Choice (EPO) |
YES |
888-632-3862 |
888-632-3862 #3 |
| HMO |
YES |
800-624-0756 |
800-624-0756 #3 |
| Managed Choice POS |
YES |
888-632-3862 |
888-632-3862 #3 |
| Open Access Aetna Select |
NO |
888-632-3862 |
888-632-3862 #3 |
| Open Access Elect Choice |
NO |
888-632-3862 |
888-632-3862 #3 |
| Open Access HMO |
NO |
800-624-0756 |
800-624-0756 #3 |
| Open Access Managed Choice POS |
NO |
888-632-3862 |
888-632-3862 #3 |
| Open Choice PPO & NAP |
NO |
888-632-3862 |
888-632-3862 #3 |
| Quality Point of Service (QPOS) |
YES |
800-624-0756 |
800-624-0756 #3 |
| Traditional Choice (Indemnity) |
NO |
888-632-3862 |
888-632-3862 #3 |
| US Access HMO |
NO |
800-624-0756 |
800-624-0756 #3 |
| Aetna Affordable Health Choices (PPO) |
NO |
888-772-9682 |
888-772-9682 |
| Commercial, HMO & PPO |
Referral
Required
to see
Specialist |
Member
Eligibility |
Pre Certification
and Referrals |
| Anthem Blue Cross/Blue Shield www.anthem.com |
| BlueCare HMOs: |
|
|
|
| BlueCare |
NO |
800-922-3242 |
800-238-2227 |
| BlueCare Plus |
YES |
800-922-3242 |
800-238-2227 |
| BlueCare Plus Access 10 |
YES |
800-922-3242 |
800-238-2227 |
| BlueCare Plus Basic Health Plan |
NO |
800-922-3242 |
800-238-2227 |
| BlueCare Plus Direct |
YES |
800-922-3242 |
800-238-2227 |
| BlueCare Plus POS |
YES |
800-922-3242 |
800-238-2227 |
| BlueCare POS |
NO |
800-922-3242 |
800-238-2227 |
| Blue Options: |
|
|
|
| Century Preferred |
NO |
800-922-3242 |
800-238-2227 |
| Century Preferred Direct PPO |
NO |
800-922-3242 |
800-238-2227 |
| Century Preferred Comp |
NO |
800-922-3242 |
800-238-2227 |
| New England Health Plans (formerly HMO Blue New England): |
|
|
|
| Access Blue New England |
NO |
800-676-2583 |
800-676-2583 |
| Blue Choice New England |
YES |
800-676-2583 |
800-676-2583 |
| HMO Blue New England |
YES |
800-676-2583 |
800-676-2583 |
| Small Employer Plan Comprehensive: |
Call to verify |
Call # on ID Card |
Call # on ID Card |
| State of CT Employees: |
|
|
|
| State Preferred (PPO) |
NO |
800-922-2232 |
800-238-2227 |
| State BlueCare POS |
NO |
800-922-2232 |
800-238-2227 |
| State BlueCare POE |
NO |
800-922-2232 |
800-238-2227 |
| State BlueCare POE Plus |
YES |
800-922-2232 |
800-238-2227 |
| Federal Employee Program: |
|
|
|
| Federal Employee Plan (Basic Option) |
NO |
800-438-5356 |
800-860-2156 |
| Federal Employee Plan (Standard Option) |
NO |
800-438-5356 |
800-860-2156 |
| Anthem Other: |
|
|
|
| Anthem PPO (Anthem Employees) |
NO |
800-922-3242 |
800-238-2227 |
| BlueCare/BlueCard PPO |
Call to verify |
800-676-2583 |
800-676-2583 |
| Century (90,94,96, 9D, 9T, 98) |
NO |
800-922-3242 |
800-238-2227 |
| National Accounts (Includes Teamsters) |
NO |
800-233-6183 |
800-238-2227 |
| Commercial, HMO & PPO |
Referral
Required
to see
Specialist |
Member
Eligibility |
Pre Certification
and Referrals |
| Cigna Health Care www.cigna.com |
| HMO, Network, POS |
YES |
800-882-4462 |
800-882-4462 or on-line |
| PPO, EPO, Indemnity, Open Access |
NO |
800-882-4462 |
800-882-4462 or on-line |
| ConnectiCare www.connecticare.com |
| ConnectiCare PPO |
NO |
800-562-6834 #1 |
800-562-6834 #2 |
| HMO-Open Access |
NO |
800-562-6834 #1 |
800-562-6834 #2 |
| HMO-Personal Care Plan |
YES |
800-562-6834 #1 |
800-562-6834 #2 |
| POS Open Access Plan |
NO |
800-562-6834 #1 |
800-562-6834 #2 |
| POS-Personal Care plan |
YES |
800-562-6834 #1 |
800-562-6834 #2 |
| Great-West HealthCare (formerly One Health Plan) |
Varies by Employer |
800 882-4462
888-663-8081 |
800 882-4462
888-663-8081 |
| Health
Net www.healthnet.com |
| Charter HMO and Charter POS |
NO * |
800-438-7886
Auto Referral 800-622-7708 |
800-438-7886
Auto Referral 800-622-7708 |
| Passport HMO and Passport POS |
YES |
800-438-7886
Auto Referral 800-622-7708 |
800-438-7886 Auto Referral 800-622-7708 |
| HMC PPO (Health Management Center) |
Varies by Employer |
Call # on ID Card |
Call # on ID Card |
| Multiplan - participating as of 2/15/04 |
Varies by Employer |
Call # on ID Card |
Call # on ID Card |
| Commercial, HMO & PPO |
Referral
Required
to see
Specialist |
Member
Eligibility |
Pre Certification
and Referrals |
| Oxford Health Plans www.oxfordhealth.com |
| Freedom Plan Access |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan Classic |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan Direct |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan Laurel |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan Laurel Select |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan POS |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan Value Option |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plans PPO |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Freedom Plan HMO Laurel |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Freedom |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Laurel |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Laurel Select |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Liberty |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Select |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Select-Freedom Network |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| HMO Select-Liberty Network |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Liberty Plan Access |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Liberty Plan Classic |
YES |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Liberty Plan Select PPO |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Oxford HSA Direct |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Oxford HSA Exclusive |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Oxford My plan |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Oxford Exclusive Plan Metro |
NO |
800-666-1353 |
online at www.oxhp.com
or fax # 800-303-9902 |
| Commercial, HMO & PPO |
Referral
Required
to see
Specialist |
Member
Eligibility |
Pre Certification
and Referrals |
| PHCS (Private Healthcare Systems) |
Varies by Employer |
Call # on ID Card |
Call # on ID Card |
| Tricare www.healthnetfederalservices.com |
| Tricare Extra |
NO |
1-877-874-2273 |
1-877-874-2273 |
| Tricare Prime |
YES |
1-877-874-2273 |
1-877-874-2273 |
| Tricare Prime POS |
NO |
1-877-874-2273 |
1-877-874-2273 |
| Tricare Prime Remote |
YES (for family, not ADSM) |
1-877-874-2273 |
1-877-874-2273 |
| Tricare Standard |
NO |
1-877-874-2273 |
1-877-874-2273 |
| United Healthcare www.unitedhealthcareonline.com |
| |
NO |
800-822-3806 |
877-842-3210 |
Note: Anesthesiology is participating with United Healthcare as of 11/1/08. |
Yale Health Plan |
YES |
203-432-0246 |
203-432-0246 |
| Medicaid Managed Care |
| Aetna Better Health (par as of 1/1/09) (www.aetnabetterhealth.com |
NO |
1-866-742-3120 |
1-866-742-3120 |
| Blue Care Family Plan (no longer a Medicaid Managed Care plan as of 2/1/09) |
YES |
800-828-2239 |
800-828-2239 |
| Community Health Network (www.chnct.org) |
NO |
CHN 800-440-5071
HUSKY 800-859-9889
SAGA 866-361-7242 |
CHN 800-440-5071
HUSKY 800-859-9889
SAGA 866-361-7242 |
| United Healthcare Americhoice (par as of 1/1/09) (www.americhoice.com) |
NO |
866-573-2451 |
866-573-2451 |
| Medicare Managed Care |
| Aetna Golden Medicare Plan (HMO) |
Yes |
800-624-0756 |
800-624-0756 #3 |
| Aetna Golden Choice Plan (PPO), Aetna Golden Medicare Open Access |
NO |
800-624-0756 |
800-624-0756 #3 |
| Anthem Medicare Advantage (MediBlue) (Member must reside in either Fairfield, Hartford or New Haven County) |
NO |
866-364-2374 |
866-364-2374 |
| Connecticare (Medicare) Effective 11/1/08 |
NO |
800-562-6834 #1 |
800-562-6834 #2 |
| Health Net Medicare Advantage (formerly Smart Choice) |
NO |
800-438-7886 |
800-438-7886 |
| Tricare For Life |
NO |
1-866-773-0404 |
1-866-773-0404
(only req. for mental health services) |
| Charter Oak |
| Aetna Better Health (par as of 1/1/09) |
NO |
1-866-742-3120 |
1-866-742-3120 |
| Community Health Network (CHN) (nonpar) |
YES |
1-800-440-5071 |
1-800440-5071 |
| United Healthcare Americhoice (par as of 1/1/09) |
NO |
866-573-2451 |
866-573-2451 |
| Worker's
Compensation |
| All carriers registered with State of CT |
Yes |
call # on pg 2 of Case screen |
call # on pg 2 of Case screen |
| Yale - New Haven Hospital (YNHH) |
Yes |
203-688-1974 |
203-688-1974 |
| Yale University |
Yes |
203-432-7397 |
203-432-7397 |
| Non-Participating
Plans (Require Out-of-Network Referral from Health Plans): |
| CHN Charter Oak Health Plan |
YES |
1-800-440-5071 |
1-800-440-5071 |
| Community Care Network |
YES |
Call # on ID Card |
Call # on ID Card |
| FirstChoice (Medicaid) (Termed as of 4/1/08) |
|
|
|
| Health Net Healthy Options (Medicaid) (Termed as of 4/1/08) |
|
|
|
| Oxford Medicare (Secure Horizons) (Termed as of 12/31/08) (Members do not have OON benefits) |
YES * |
800-666-1353 |
online at www.oxhp.com or fax # 800-303-9902 |
United Healthcare Evercare (Medicare)
evercarehealthplans.com |
|
|
1-877-702-5110 |
| Wellcare (Medicare) |
YES |
800-925-3606 |
800-925-3606 |
| Participating
For Yale Pathology (Bridgeport and Therapeutic Radiology Providers
at L&M and Backus ONLY: |
| Northeast Health Direct |
Varies
by Employer |
Call
# on ID Card |
Call
# on ID Card |
Health Insurance Guide 
