Participating Health Plans
Available Health Plans
Availity offers health care professionals a single, HIPAA compliant gateway through which they can transact with multiple health plans, resulting in cost and time savings to both communities. Availity supports real-time web-based and batch transactions with the health plans listed on this page. We encourage health plans to Contact Us today to learn how to add value to their provider relationships while saving time and operational costs.
Health Plans That Support Batch Clearinghouse Transactions
More than 1,000 health plans are supported nationwide.
Health Plans That Support Real-Time Web-Based Transactions
All Blue Cross and Blue Shield plans are supported through the Blue plan where patient services are rendered. Currently, Aetna, CIGNA, and Humana are the only real-time health plans available outside the state of Florida.
Aetna is one of the nation's leading providers of health care and related group benefits, serving approximately 15.0 million health care members, 12.1 million dental members, and 11.9 million group insurance customers as of March 31, 2002. Information about Aetna is available at www.aetna.com.
 Americas Health Choice Medical Plans, Inc. is a closed panel Florida Medicare +Choice HMO that was formed in July 2000. It is the leading Medicare+Choice HMO in the Treasure Coast and the fastest growing Medicare+Choice HMO in Palm Beach County. In three years the Company has distinguished itself among other HMOs in terms of ability to contain medical costs and the high level of benefits offered to its members. America’s Health Choice Medical Plans, Inc. emphasizes prevention, early disease detection, and treatment. Its network includes twenty-six well-equipped and fully-staffed medical centers in Broward, Brevard, Indian River, St. Lucie, Martin, Okeechobee, and Palm Beach Counties with a large number of hospitals, specialists, and ancillary health care providers. While other managed care plans are withdrawing from the Medicare market, America’s Health Choice is growing and expanding its geographic service area and its product offerings. For more information, please visit www.ahcmp.net.
 AvMed Health Plans has been providing Floridians access to healthcare for over 35 years. Through an extensive broker network, AvMed offers health care coverage solutions for large and small businesses around the state. AvMed’s competitive rates and highly personalized service are valued by clients, many of whom have been with AvMed for over 15 years. Headquartered in Florida, AvMed has offices in Miami, Ft. Lauderdale, Orlando, Tampa, Gainesville and Jacksonville. Additionally, AvMed offers health care products to Medicare beneficiaries in Miami-Dade and Broward counties in South Florida. For more information, visit www.AvMed.org.
 Blue Cross Blue Shield of Arizona, an independent licensee of the Blue Cross and Blue Shield Association, is the largest Arizona-based health insurance company. The not-for-profit company was founded in 1939 and provides health insurance products, services, or networks to more than 1.1 million individuals. With offices in Phoenix, Flagstaff, Tempe, and Tucson, the company employs more than 1,500 Arizonans. For information about Blue Cross Blue Shield of Arizona and its community programs such as Walk On!, please visit www.azblue.com.
 As Florida's largest health care company, Blue Cross and Blue Shield of Florida and its subsidiaries serve more than 6 million Floridians. Since 1944, the company has been dedicated to providing caring solutions that meet the diverse and ever-changing needs of all those it serves by offering an array of affordable health care choices. For more information, please visit www.bcbsfl.com.
 Blue Cross and Blue Shield of Illinois (BCBSIL) is the largest and most experienced health insurance company in the state of Illinois, providing more than 6.5 million members with comprehensive and affordable health plans. As a division of Health Care Service Corporation (HCSC), BCBSIL provides its members with a high level of confidence and security. The people of BCBSIL are committed to the highest standards of business ethics and integrity, and are committed to fulfilling the corporate citizenship responsibilities to the communities they serve. For more information, please visit www.bcbsil.com.
 For more than 65 years, Blue Cross and Blue Shield of New Mexico (BCBSNM) has been committed to the health needs of the state, developing new and innovative products to meet the demands of a changing market. BCBSNM offers a complete continuum of health plans, including Point-of-Service, HMO, PPO, indemnity, and individual health plans. BCBSNM serves more than 252,000 individuals, employees, and family members, with the most comprehensive provider networks in the state. For additional information, please visit www.bcbsnm.com.
 Throughout its 65-year history, Blue Cross and Blue Shield of Oklahoma (BCBSOK) has been committed to meeting the health care financing needs of Oklahomans. As the state's oldest and largest private health insurer, BCBSOK and related subsidiaries in Oklahoma provide benefit plans for more than 835,000 Oklahomans. BCBSOK is a division of Health Care Service Corporation (HCSC), a Mutual Legal Reserve Company. For additional information, please visit www.bcbsok.com.
 Blue Cross and Blue Shield of Texas (BCBSTX) is a non-investor-owned health insurance company--the only one serving every corner of the state. Foundational to BCBSTX is access to affordable, quality health care and top-notch service. As a division of Health Care Service Corporation (HCSC), BCBSTX is among the strongest health insurers in the nation, providing its members with a high level of confidence and security. For additional information, please visit www.bcbstx.com.
 Capital Health Plan (CHP) is a non-profit health plan that was begun by local citizens in Tallahassee, Florida in 1982 and now serves Leon, Gadsden, Jefferson, and Wakulla counties. CHP is an affiliate of Blue Cross Blue Shield of Florida and an independent licensee of the Blue Cross and Blue Shield Association. CHP has achieved "Excellent" accreditation from the National Committee for Quality Assurance, and also has been recognized for its high levels of member satisfaction and quality of care. For more information, please visit www.capitalhealth.com.
 CarePlus Health Plans, Inc. is a recognized leader and innovator in healthcare delivery throughout Florida with operations in Florida for almost ten years. CarePlus is committed to enriching the healthcare experience for consumers and business partners through the provision of Medicare Advantage HMO health plans. CarePlus is a Medicare Advantage organization with a Medicare contract and membership of nearly 53,000 Medicare beneficiaries located in Miami-Dade, Broward, Palm Beach, Hillsborough and Pinellas counties. Beginning November 15, 2007 CarePlus will begin enrollment for 2008 Medicare Advantage plans in those counties plus Pasco, Orange, Osceola and Seminole counties. For additional information, please visit www.careplus-hp.com.
CIGNA HealthCare offers a broad range of group medical, dental, behavioral, pharmacy and life products, and designs benefit programs to meet the needs of employers of all sizes. The CIGNA HealthCare companies comprise one of the nation's leading providers of health-benefit programs with products marketed in all 50 states, the District of Columbia and Puerto Rico. To learn more, go to www.cigna.com.
Citrus Health Care is a Florida based HMO and is staffed with an experienced and knowledgeable management team. Citrus Health Care, Inc. (CHC) was incorporated on February 14, 2003 to provide quality health care for the people of Florida. A well established health care company offering comprehensive health care coverage throughout Florida in the following counties: Hernando, Lake, Hillsborough, Pasco, Pinellas, Volusia, Sarasota, Manatee, Polk, Orange, Osceola, Seminole, Citrus, Marion, Broward, Miami-Dade, Palm Beach and St. Lucie, and dedicated to providing you with high quality care & services. For more information, please visit www.citrushc.com.
Florida Hospital Healthcare System (FHHS) is a fully integrated comprehensive healthcare system. They have been a licensed third party administrator (TPA) since 1995 and are administering healthcare benefit programs for some of Central Florida's major employers. FHHS offers a full array of services including benefit plan administration, account management, benefits/eligibility, customer service, claims management, finance, information systems management, reports and network administration/credentialing, and full utilization management services. All administrative services are based in Orlando and one central location, premiering their comprehensive case and disease management system. For more information, please visit www.fhhs.net.
 For nearly 50 years, Great-West Healthcare has pioneered new ideas from the frontier of health care, offering creative benefit solutions that engage employees and help businesses manage costs. As a national employee benefits provider, we continue to forge ahead by evolving our portfolio of benefits and funding solutions to meet the ever-changing needs of the health care industry. Great-West Healthcare provides coverage to 2.2 million people through a national network of more than 4,275 hospitals and 578,000 physician and ancillary providers. As a leader in consumer-driven health care, we offer a variety of helpful publications, tools and resources to provide customers with education and guidance to make informed health care choices. For more information, please visit www.greatwesthealthcare.com.
 Humana, headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health services companies, with approximately 6.5 million medical members located primarily in 18 states and Puerto Rico. Humana offers coordinated health benefits coverage through a variety of plans - health maintenance organizations, preferred provider organizations and administrative service products - to employer groups, and government-sponsored plans. For more information, please visit www.humana.com.
 Leon Medical Centers (LMC) is a managed health care system offering superior comprehensive services and presently operating in Miami-Dade County, Florida. LMC operates in conjunction with Leon Medical Centers Health Plans, Inc. (LMCHP), an HMO with a Medicare Advantage contract offered exclusively to patients of LMC. LMC is also a provider for Preferred Care Partners members. For more information, please visit www.lmchealthplans.com.
 Medicaid is a program that pays for medical assistance for certain individuals and families with low incomes and resources. This program became law in 1965 and is jointly funded by the Federal and State governments (including the District of Columbia and the Territories) to assist States in providing medical long-term care assistance to people who meet certain eligibility criteria. Medicaid is the largest source of funding for medical and health-related services for people with limited income. For more information, please visit www.cms.hhs.gov.
 In 1965, the Social Security Act established both Medicare and Medicaid. Medicare was a responsibility of the Social Security Administration (SSA), while Federal assistance to the State Medicaid programs was administered by the Social and Rehabilitation Service (SRS). SSA and SRS were agencies in the Department of Health, Education, and Welfare (HEW). In 1977, the Health Care Financing Administration (HCFA) was created under HEW to effectively coordinate Medicare and Medicaid. In 1980 HEW was divided into the Department of Education and the Department of Health and Human Services (HHS). In 2001, HCFA was renamed the Centers for Medicare & Medicaid Services (CMS). CMS is the federal agency, which administers the Medicare Program. Medicare is the national health insurance program for people age 65 or older, some people under age 65 with disabilities, and people with End-Stage Renal Disease (ESRD). For more information, please visit www.cms.hhs.gov.
METCARE Health Plans, Inc., a wholly owned subsidiary of Metropolitan Health Networks, Inc. (AMEX:MDF) (PCX:MDF), is a Florida-focused health maintenance organization providing health care services to people with Medicare through its AdvantageCaresm Medicare Advantage health plans, now available in Lee, Charlotte, Sarasota, Martin, St. Lucie and Okeechobee counties. To learn more about METCARE, please visit www.metcare.com.
Headquartered in Central Florida and owned by local doctors, Physicians United Plan provides healthcare coverage and prescription drug benefits to people with Medicare. As an alternative to traditional Medicare, Physicians United Plan is proud to offer its special brand of personalized customer service with its Hometown Spirit and Hometown Reward products. Physicians United Plan is available to residents of Lake, Marion, Orange, Osceola, Polk, Seminole and Sumter counties. More information about Physicians United Plan can be obtained by visiting www.pupcorp.com or by calling 866-571-0693.
UnitedHealth Group is a diversified health and well-being company dedicated to making health care work better. Headquartered in Minneapolis, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare, Ovations, AmeriChoice, Uniprise, Specialized Care Services and Ingenix. Through its family of businesses, UnitedHealth Group serves approximately 70 million individuals nationwide. For more information, please visit www.unitedhealthcare.com.
VISTA, together with its affiliated companies, Vista Insurance Plan, Inc. and Vista Healthplan of South Florida, Inc., offer a choice of health benefits plans including health maintenance organization (HMO), preferred provider organization (PPO) and point-of-service (POS). Headquartered in Hollywood, Florida, the VISTA companies provide health benefits coverage to more than 350,000 members through employer group and individual plans, Medicare+Choice, Medicaid and Florida Healthy Kids programs. For more information, please visit www.vistahealthplan.com.
WellCare is a leading provider dedicated to government-sponsored health plans such as Medicare, Medicaid, State Children’s Health Insurance Programs and others. Founded in 1985, our team of more than 2,600 associates, over 25,000 physician partners and 60,000+ pharmacies serve over 2 million members across the country. The WellCare Group of Companies operates plans under the WellCare, Staywell, HealthEase, Harmony and PreferredOne brands. WellCare's recent launches include stand-alone Prescription Drug Plans and Open Access Private Fee-For-Service Plans. Our company headquarters are based in Tampa, FL. Regional offices include: Miami, FL; Manhattan, NY; North Haven, CT; Baton Rouge, LA; Marietta, GA; and Chicago, IL; which is also headquarters for Harmony Health Plan. For more information, please visit www.wellcare.com.
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