Dr. Rainville and Dr. Matier participate with the following Insurance Companies:

 

They accept but are out of network providers for Qualcare.

 

Horizon Blue Cross Blue Shield

  • Omnia Tier 1 (ONLY)
  • Omnia Bronze
  • Omnia Silver
  • Omnia Silver HSA
  • Omnia Platinum
  • Omnia HAS
  • Omnia Gold
  • NJ Direct MA PPO
  • NJ Direct
  • Horizon Patient-Centered Adv EPO
  • Horizon POS
  • Horizon Medicare Blue Choice w/Rx (HMO)
  • Horizon Medicare Blue Value (HMO)
  • Horizon Medicare Blue Value w/Rx (HMO)
  • Horizon MyWay HRA Direct Access
  • Horizon MyWay HSA Direct Access
  • Horizon Medicare Blue Choice w/Rx (HMO)
  • Horizon Medicare Blue Value (HMO)
  • Horizon Medicare Blue Value w/Rx (HMO)
  • Horizon MyWay HRA Direct Access
  • Horizon MyWay HSA Direct Access
  • Horizon Medicare Blue Choice w/Rx (HMO)
  • Horizon Medicare Blue Patient-Centered w/Rx (HMO)
  • Horizon Medicare Blue Value (HMO)
  • Horizon Medicare Blue Value w/Rx (HMO)
  • Horizon MyWay HRA Direct Access
  • Horizon MyWay HSA Direct Access

Cigna

  • Open Access Plus, OA Plus ChoiceFund OA Plus
  • Open Access Plus OA Plus, ChoiceFund OA Plus with CareLink
  • PPO, Choice Fund PPO
  • Network, HMO, POS

United Healthcare

  • Choice
  • Choice HMO
  • Choice Plus
  • Choice Plus with Harvard Pilgrim
  • Choice with Harvard Pilgrim
  • CORE
  • CORE Essential
  • CORE HMO/CORE Essential HMO
  • Heritage Plus
  • Heritage Select POS/HMO
  • Heritage Select EPO
  • Heritage Select Advantage – IA
  • HERITAGE SELECT ADVANTAGE – AR, GA, NC, SC, TN
  • NAVIGATE HMO / NAVIGATE BALANCED HMO / NAVIGATE PLUS HMO
  • NAVIGATE / NAVIGATE BALANCED
  • NAVIGATE PLUS
  • NexusACO (Tier 1 Only)
  • OPTIONS PPO
  • OPTIONS PPO WITH HARVARD PILGRIM
  • Select
  • Select HMO
  • Select Plus
  • AARP MedicareComplete Essential (HMO) – Rainville Only at Clara Maass
  • AARP MedicareComplete Plan 1 (HMO) – Rainville Only at Clara Maass
  • AARP MedicareComplete Plan 2 (HMO) – Rainville Only at Clara Maass
  • AARP MedicareComplete Plan 3 (HMO) – Rainville Only at Clara Maass
  • AARP MedicareComplete Plan 4 (HMO) – Rainville Only at Clara Maass
  • UnitedHealthcare Dual Complete ONE (HMO SNP) – Rainville Only at Clara Maass
  • UnitedHealthcare Group Medicare Advantage (HMO) – Rainville Only at Clara Maass
  • UnitedHealthcare Group Medicare Advantage (PPO) – Rainville Only at Clara Maass
  • UnitedHealthcare Nursing Home Plan (HMO SNP) – Rainville Only at Clara Maass
  • UnitedHealthcare Nursing Home Plan (PPO SNP) – Rainville Only at Clara Maass

AmeriHealth

  • AmeriHealth Advantage (Tier 2)
  • AmeriHealth Advantage Network for 2018 (Tier 2)
  • Local Value Network
  • Tier 1Advantage
  • Tier 1 Advantage for 2018

Horizon NJ Health

  • Horizon NJ Health
  • Horizon NJ TotalCare (HMO SNP)

Aetna

  • (CT) Aetna Whole Health – Hartford HealthCare & Value Care Alliance
  • (ME) Aetna Whole Health℠- Maine – Aetna Select
  • (ME) Aetna Whole Health℠- Maine – Health Network Only/Option
  • (NC) Aetna Whole Health℠- Duke Health & WakeMed
  • (NJ) Aetna Whole Health℠- Hackensack Meridian Health
  • (NJ) Aetna Whole Health℠- Virtua
  • (TN) Aetna Whole Health Tennessee
  • (TX) PCP Referral Plan
  • (VA) Aetna Whole Health℠- Coastal Virginia Health Partners
  • (VA) Aetna Whole Health℠- VA Preferred – Roanoke
  • NAP (National Advantage Plan)
  • Aetna Choice® POS (Aetna HealthFund®)
  • Aetna Choice® POS (Open Access)
  • Aetna Choice® POS II (Aetna HealthFund®)
  • Aetna Choice® POS II (Open Access)
  • Aetna DC Bronze, Silver and Gold Open Access Health Network Only
  • Aetna DC Bronze, Silver and Gold Open Access Managed Choice
  • Aetna DC Silver and Gold PPO
  • Aetna DE Bronze, Silver and Gold PPO
  • Aetna DE Bronze, Silver and GoldOpen Access Health Network Option
  • Aetna Health Network Only℠(Open Access)
  • Aetna Health Network Option
  • Aetna HealthFund® Aetna Health Network Only℠(Open Access)
  • Aetna HealthFund® Aetna Health Network Option℠(Open Access)
  • Aetna MD Bronze, Silver and Gold Open Access Health Network Only
  • Aetna MD Bronze, Silver and Gold PPO
  • Aetna Medicare℠Plan (HMO / Open Access HMO)
  • Aetna Medicare℠Plan (PPO)
  • Aetna Open Access® Elect Choice® EPO (Aetna HealthFund®)
  • Aetna Open Access® Managed Choice® POS (Aetna HealthFund®)
  • Aetna Premier Care Network Plus – Duke Health & WakeMed
  • Aetna Premier Care Network Plus – Baptist Health System & Health Texas Medical (2017 providers)
  • Aetna Premier Care Network Plus – Baptist Health System & Health Texas Medical
  • Aetna Premier Care Network Plus – CHI Health Accountable Care Network (2017 providers)
  • Aetna Premier Care Network Plus – CHI Health Accountable Care Network
  • Aetna Premier Care Network Plus – INTEGRIS Health Partners Network
  • Aetna Premier Care Network Plus – Maine
  • Aetna Premier Care Network Plus – MemorialCare
  • Aetna Premier Care Network Plus – Mercy Health Toledo
  • Aetna Premier Care Network Plus – PinnacleHealth
  • Aetna Premier Care Network Plus – Puget Sound
  • Aetna Premier Care Network Plus – St. John Oklahoma Health Initiative
  • Aetna Premier Care Network Plus – Texas Health
  • Aetna Premier Care Network Plus – Virtua
  • Aetna Premier Care Network Plus – WellSpan Provider Network
  • Aetna Premier Care Network Plus-Banner Health Network
  • Aetna Premier Care Network Plus-Banner Health Network
  • Aetna Premier Care Network Plus-Baylor Scott & White Quality Alliance
  • Aetna Premier Care Network Plus-Colorado Front Range
  • Aetna Premier Care Network Plus-Colorado Front Range
  • Aetna Premier Care Network Plus-Innovation Health
  • Aetna Premier Care Network Plus-Innovation Health
  • Aetna Premier Care Network Plus-Integris Network (2017 Providers)
  • Aetna Premier Care Network Plus-Memorial Hermann Accountable Care Network
  • Aetna Premier Care Network Plus-Memorial Hermann Accountable Care Network
  • Aetna Premier Care Network Plus-Mercy Health Cincinnati
  • Aetna Premier Care Network Plus-Mercy Health Cincinnati
  • Aetna Premier Care Network Plus-Seton Health Alliance
  • Aetna Premier Care Network Plus-Seton Health Alliance
  • Aetna Select
  • Aetna Value Performance Network℠(2015)
  • Aetna Value Performance Network℠(2016)
  • Aetna Voluntary Plans
  • Banner Choice POS II Multi Tier
  • Choice POS II
  • Elect Choice® EPO (Open Access)
  • Elect Choice® EPO
  • HMO (Open Access)
  • HMO / Health Network Only
  • HMO
  • Kansas Connector Elect Choice EPO
  • Kansas Connector Managed Choice
  • Kansas Connector Preferred Elect Choice EPO
  • Kansas Connector Preferred Managed Choice
  • Managed Choice Open Access/Managed Choice
  • Managed Choice® (Open Access)
  • Managed Choice® POS
  • Mercy Preferred Aetna Choice POSII
  • Mercy Preferred Aetna Select (Open Access)
  • Mercy Preferred Elect Choice EPO (Open Access)
  • Mercy Preferred Managed Choice (Open Access)
  • Mercy Preferred Open Choice (PPO)
  • Open Choice® PPO (Aetna HealthFund®)
  • Open Choice® PPO
  • PPO
  • Peak Preference (Open Access) Aetna Select
  • Peak Preference HNOnly (Open Access) on the Altius Network
  • Peak Preference HNOption (Open Access) on the Altius Network
  • QPOS®
  • SW MO Region Premier Aetna Select (Open Access)
  • SW MO Region Premier Elect Choice EPO (Open Access)
  • Savings Plus of Amarillo, TX
  • Savings Plus of Lake County, OH
  • Savings Plus of Longview, TX
  • Savings Plus of Massachusetts-OA Aetna Select
  • Savings Plus of Massachusetts-OA Managed Choice
  • Savings Plus of Massachusetts-POSII
  • Savings Plus of Metro, NY
  • Savings Plus of New Jersey Choice POS II
  • Savings Plus of New Jersey-HMO/HNO
  • Savings Plus of New Jersey-POSII
  • Savings Plus of Ohio-POSII
  • Savings Plus of Southeast Pennsylvania AFA-POSII
  • Savings Plus of Southeast Pennsylvania Aetna Select Open Access
  • Savings Plus of Southeast Pennsylvania Aetna Select
  • Savings Plus of Southeast Pennsylvania Choice POS II
  • Savings Plus of Southeast Pennsylvania HNOption/HMO/QPOS
  • Savings Plus of Southeast Pennsylvania Managed Choice Open Access
  • Savings Plus of Southeast Pennsylvania Managed Choice
  • Savings Plus of Southeast Pennsylvania Open Choice PPO
  • Savings Plus of Tennessee
  • Utah Connected Network – Aetna Choice POS II (Open Access)
  • Utah Connected Network – Aetna Select (Open Acess)
  • Utah Connected Network – Aetna Select
  • Utah Connected Network – Elect Choice EPO (Open Access)
  • Utah Connected Network – Elect Choice EPO
  • Utah Connected Network – Managed Choice POS (Open Access)
  • Utah Connected Network – Managed Choice POS
  • Utah Connected Network – Open Choice PPO
  • Wesley Preferred Managed Choice (Open Access)

Magnacare

  • Maritain Health (Must confirm Coverage for Bariatrix)
  • Medicare
  • OSCAR

Dr. Ballem and Dr. Gohill are in network with the following plans…

Medicare, HMC Aetna, Qualcare, NJ Family Health (BCBS product), Barnabas Health insurance

 

Please call our office to discuss a consultation and a full
analysis of your requirements: 973-744-8585

 

For the Out of Network policies our pricing follows the data on https://www.fairhealthconsumer.org/
As network status and pricing may change before updated on this website, please consult with the financial advisor at the office to understand your healthcare plan, benefits, copays, and deductibles.

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