Call Us: (704) 887-1101
Independently Owned and Operated since 2004

Insurance

Health insurance exchange (i.e., Obamacare exchange, ACA exchange) 
Many of our patients have inquired about which plans Sensenbrenner Primary Care will participate with that are being offered on the health insurance exchange. NC patients wishing to shop for health insurance through the exchange will need to visit https://www.healthcare.gov/.

2016/2017 enrollment
For 2016/2017, Aetna and United Healthcare have dropped out of the exchange. That leaves North Carolina residents with one insurer, BCBS. In the Charlotte region, specifically Mecklenburg County, there are two BCBS plans to choose from, Blue Local w/ CHS and Blue Value. Both are limited network plans. Unfortunately, we are still out of network with both plans. Just as we did last year, we have contacted BCBS to try gain access to the Blue Value network. As of 10/31/16, we have not received a response.
*If you choose Blue Value or Blue Local w/ CHS and want to keep Sensenbrenner Primary Care as your PCP, we will collect payment in full at time of service. A $100 pre-payment will be collected at CHECK-IN and any balance due or refunds due will be settled at the end of your visit. A detailed receipt with CPTs/ICD10s will be provided to you by mail or patient portal so that you can file your own claim to your insurer in the event you have any out of network benefits.

South Carolina residents can choose variations of a plan “BlueEssentials Individual and Family” that is also a limited network plan. We are out of network with that plan as well. *If you choose Blue Essentials Individual and Family and want to keep Sensenbrenner Primary Care as your PCP, we will collect payment in full at time of service. A $100 pre-payment will be collected at CHECK-IN and any balance due or refunds due will be settled at the end of your visit. A detailed receipt with CPTs/ICD10s will be provided to you by mail or patient portal so that you can file your own claim to your insurer in the event you have any out of network benefits.

*Please note we ARE in network with “Business Blue Essentials”, a South Carolina BCBS plan.


Medicare 
Sensenbrenner Primary Care is a participating provider for TRADITIONAL Medicare (Part B) ONLY. We do NOT accept any Medicare Advantage Plans (Part C, or ‘MA’). Medicare Advantage plans are sold by many companies and go by many different names. Please ask us if we participate before you switch.
*If you choose a Medicare Advantage Plan and want to keep Sensenbrenner Primary Care as your PCP, we will collect payment in full at time of service. A $100 pre-payment will be collected at CHECK-IN and any balance due or refunds due will be settled at the end of your visit. A detailed receipt with CPTs/ICD10s will be provided to you by mail or patient portal so that you can file your own claim to your insurer in the event you have any out of network benefits.


Commercial insurance
Aetna
BCBS NC: Blue Advantage PPO, Blue Care HMO, Blue Classic CMM, Blue Options PPO, Blue Select PPO, NC State Employees Health Plan
BCBS out of state PPO
Cigna, Cigna/Great West
Coventry
HealthGram (formerly Primary Physician Care)
Medcost
United Healthcare


Self-Pay (no insurance)
We do accept self-pay patients. Payment in full is expected at the time services are rendered. Upon checking in at the front desk, you will be expected to pay a $100.00 pre-payment. At check-out, the provider will indicate what services were rendered and the balance of your visit is due prior to leaving. If the services total less than $100.00, you will be refunded the difference.

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