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Boulder Medical Center Insurance Information

About Contracted Insurance Plans

  • As a patient, you are responsible for knowing if Boulder Medical Center (BMC) doctors are contracted with your insurance plan.
  • The best way to confirm this is to contact your insurance company and provide them with Boulder Medical Center’s tax ID (84-0834835) and NPI (1306820923).

About Non-Contracted Insurance Plans

  • If Boulder Medical Center (BMC) is not contracted with your insurance provider, you will receive a service estimate at least five days before your appointment. The estimated amount must be paid on the day of your visit.
  • Please note that this estimate is a minimum amount. Additional charges may apply for treatments or procedures received during your appointment. You are responsible for the full cost of services and will be billed for any remaining balance.
  • If the amount you paid exceeds the final billed charges, you will receive a refund within two weeks of your appointment.
  • As a courtesy, BMC will copy/scan your insurance card and submit a one-time claim to your insurance provider.

Boulder Medical Center (BMC) accepts these Health Insurance Plans

Aetna

  • EPO
  • GEHA
  • HMO
  • Indemnity NAP
  • Meritain Health
  • NC NAP
  • Open Access
  • POS, POS II
  • PPO, PPO Open Choice
  • QPS
  • Select
  • US Access

Anthem Blue Cross Blue Shield

  • Anthem Ameriben CU Student Insurance
  • Blue Priority/Blue Priority HMO — needs a referral
  • Federal Employee Program
  • HMO/HMO Colorado
  • Indemnity
  • All Pathway products need a referral to be seen
  • PPO
  • Mountain Enhanced —with referral only
  • WellChoice PPO
  • NO CU Exclusive/Exclusive2 HMO plans except for Foothills and Longmont OB
  • NO MediBlue Plus
  • NO MediBlue Dual Advantage HMO/SNP
  • BlueCard out-of-area/state must have a suitcase logo on the identification card, and the back of the card says “File claims to your local BCBS”

Cigna

  • Connect — Not valid for Avista OB services
  • EPO
  • HMO – Card must say “Cigna of Colorado”
  • Indemnity
  • Local Plus/Local Plus IN
  • Network – Card must say “Cigna of Colorado”
  • Open Access Plus (card might say OA plus)
  • POS – Card must say “Cigna of Colorado”
  • PPO
  • Surefit — Not valid for Avista OB services
  • Vantage

Centivo

Cofinity

Devoted

  • Devoted Medicare Advantage

First Health Network

Kaiser

  • PPO
  • Medicare Advantage PPO

Medicaid

  • New-to-Medicaid patient by referral only
  • NO out-of-state Medicaid plan is accepted
  • NO Denver Health Medicaid plan
  • NO UHC Community Plan
  • NO CHP+ plans

Medicare

  • Medicare Part B, with or without any Medicare Supplemental Plan

PHCS – Private Health Care Systems

  • PPO
  • Multi-Plan PPO

Select Health

Tricare (Military Insurance)

  • Prime — Requires a referral
  • Remote — No referral required
  • Select — No referral required

TriWest (VA Benefits)

  • Patients have an Authorization Letter and bring the letter to their appointment.

United Healthcare

  • All Savers
  • Charter— The patient must have a Boulder Medical Center PCP or medical referral from a non-BMC primary care provider
  • Choice, Choice Plus
  • Colorado Doctors Plan
  • Compass — The patient must have a Boulder Medical Center PCP or medical referral from a non-BMC primary care provider
  • NO Community Plan (Medicaid)
  • Expatriate Ins Choice Plus
  • Golden Rule
  • Harvard Pilgrim
  • Heritage-River Valley
  • Indemnity
  • Managed Indemnity
  • Medicare Advantage
  • Navigate & Navigate IHP — Patient must have a Boulder Medical Center PCP or medical referral from a non-BMC primary care provider
  • Options PPO
  • Oxford
  • PERA
  • Select & Select Plus
  • Sierra Health + Life
  • Shared Services
  • Student Resources
  • Surest
  • Travelers
  • UMR
  • UnitedHealthOne
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