Insurance
Carilion Clinic contracts with most major health insurance carriers. We encourage you to contact your health insurance company or health benefits manager to better understand how your policy works and any financial liability that you may have, prior to receiving care.
Health Insurance Plans We Contract With
Below is a list of participating health insurance carriers (this list is updated periodically and is subject to change without notice).
Carilion Clinic Patient Access and Eligibility Assistance Services can also review the list of participating insurance plans with you. You can contact Patient Access and Eligibility Assistance Services by phone at 540-510-6400 or toll free at 1-800-928-2860.
Click here to view information about balance billing protection for out-of-network services.
Commercial Managed Care:
- Aetna Carilion Clinic Employees
- Aetna Regular Commercial (BoB-Book of Business)
- Aetna Virginia Preferred
- Anthem PAR/PPO/HMO
- Beach Street (Tazewell Only)
- Cigna HMO/POS/PPO
- Corvel (Tazewell Only)
- Gateway
- Integrated Health Plan (Tazewell Only)
- MedCost Virginia (aka Virginia Health Network)
- National Provider Network (Stonewall Jackson Only)
- Patient's Choice
- Private Healthcare Systems (PHCS) (Rockbridge and Tazewell Only)
- Sentara Health Plans Commercial Products
- United Healthcare OPTIONS PPO
- United Healthcare NON-OPTIONS PPO
Cardinal Care Managed Medicaid:
- Aetna Better Health of Virginia
- Anthem Healthkeepers Plus
- Humana Healthy Horizons in Virginia
- Sentara Community Plan
- United Healthcare Community Care
Medicare Advantage Plans:
- Aetna Medicare
- Aetna Medicare PRIME
- Anthem Medicare
- Humana Medicare
- Sentara Medicare
- United Healthcare Medicare
Health Insurance Marketplace Products:
- Aetna Health Exchange
- Anthem Healthkeepers HMO/Pathway X
- Sentara Health Plans - Exchange (Bronze, Silver, Gold, Platinum)
Medicare Dual Special Needs Program (DSNP):
- DSNP Aetna Better Health of Virginia
- DSNP Anthem
- DSNP Humana
- DSNP Sentara Community Complete
- DSNP United Healthcare Community Plan
Other:
- Catawba
- Tricare Humana Military
Questions to Ask Your Insurance Carrier
Here are some questions you should ask your health insurance carrier or health benefits manager:
- Do I have access to in-network health care services at Carilion Clinic?
- Does my benefit plan require me to select a primary care physician (PCP)?
- Does my plan require pre-authorization for treatment?
- Does my plan require referrals to see a specialist?
- Will I have a co-payment, a co-insurance, and/or a deductible?
Out-of-network penalties can result in a significant out of pocket expense.
