Insurance Plans
Health Plans Accepted at Our Facilities:
Aetna (PP0, POS, HMO,EPO)
Aetna Better Health
Aetna Medicare
America Health Mercy (Caritas)
Anthem Blue Cross
Assurant Health
Beechstreet Network
Champus / Tricare
Coventry Health Care
Cigna
Devon Health Network
Emerald Health Network
First Health Network (Now Aetna)
Freedom Blue Cross
Gateway Health – (Medicaid)
Gateway Health – (Medicare)
Geha
Health America /Health Assurance
Highmark Blue Cross
Highmark Blue Card
Highmark –out state plans
HM Health Insurance Co (Highmark)
Humana – In network
Intergroup Network
Mutual of Ohio (PPO / POS) thru Cigna
Medicaid –PA – Access / Access Plus
Medicaid – Ohio –Traditional
Medicare
Medicare Suppliment Plans
Mercer First Choice
Multiplan Network
National Preferred Provider Network (NPPN)
Private Health Care Systems (PHCS)
Security Blue
Tricare/ Champus
United Healthcare
United Healthcare Community plan Families
United Healthcare Community plan /Kids
United Healthcare Medicare Dual Complete
United Healthcare Medicare Complete –HMO
United Healthcare Medicare Advantage –PPO
United Healthcare Medicare AARP Complete Choice
UPMC for Kids (CHIP – HMO)
UPMC Health Plan Conversion HMO
UPMC Health Plan Conversion PPO
UPMC Health Plan Enhanced Access POS
UPMC Health Plan HMO
UPMC Health Plan Point of Service
UPMC Health Plan Premium EPO
UPMC Health Plan Premium PPO
UPMC Health Plan Premium PPO-Silver Advantage
UPMC Individual Advantage EPO
UPMC Individual Advantage –(employee plans) card says
UPMC Health Plan Standard HMO w/ referral (individual)
UPMC Health Plan Standard HMO w/ referral (small grp)
UPMC for YOU (Medical Assistance) HMO
UPMC for LIFE HMO Plan- Medicare Advantage HMO
UPMC for LIFE PPO Plan –Medicare Advantage PPO
UPMC for LIFE DUAL Plan – (Medicare/Medicaid)
UPMC Community Health Choice
Vantage PPO Network
Vantage PPO plus Network
Workers COMP –PA
Workers COMP-OH
Not covered by any of these plans? Contact us and we’ll find the best solution to suit your needs.
Edgewood Surgical Hospital – Our Commitment to Price Transparency
Effective January 1, 2021, all hospitals operating in the United States are required to provide clear, accessible pricing information online about the items and services they provide. At Edgewood Surgical Hospital, we believe that our patients have the right to know and understand the cost associated with their healthcare. We also believe it is important for our patients to fully understand their out-of-pocket financial responsibilities. Our patients should note that any out-of-pocket requirements are directly related to contractually agreed upon rates as well as any applicable co-pays, deductibles, and co-insurance requirements. Once a patient has met their maximum out-of-pocket expense or their deductible for the year, they may not owe anything. Prior to receiving any services, consumers should contact their insurance carriers for the most accurate estimate of expected out-of-pocket costs. Patients are also encouraged to contact us and speak with a financial counselor at 724-646-0400 to discuss the details of their expected services.
Things we will review:
- Your Service or Procedure
- Your Insurance – to include an evaluation of your out-of-pocket cost (Deductibles, Co-Pay, and Co-Insurance)
If you are interested in obtaining a more accurate estimate of these costs, we encourage you to contact us directly.
Hospital Charges:
In accordance with the Centers for Medicare and Medicaid Services (CMS) requirement for hospitals to post a list of their standard charges online in a machine-readable format, our file is a comprehensive list of standard charges for services provided by Edgewood Surgical Hospital and is commonly referred to as a chargemaster. Patients can learn more about this requirement at www.cms.gov.
Notes on the Chargemaster:
- Charges are subject to change and based on our commitment to patient satisfaction, we will do everything we can to keep this file updated.
- The charge amount provided is Edgewood Surgical Hospital’s standard fee for each medical service, drug, or medical supply. The charge amount is not the cost a patient should anticipate.
- The chargemaster provided is applicable to technical services performed by Edgewood which include rooms, supplies, equipment, or drugs. Patients should expect to receive additional bills for any professional services provided, including but not limited to, charges from their surgeon, radiologist, pathologist, or other professional provider that may have provided services during their visit to our facility.
- It is also important to understand that the information represented in the chargemaster for certain items or services (i.e. surgeries, anesthesia and recovery) may be based on an estimated unit of time and complexity. Accordingly, these items and services may be difficult to accurately estimate in advance.
Edgewood Surgical Hospital