Insurance
Insurance that keeps YOUR CARE
ACCESSIBLE
Navigating coverage details can sometimes be complex, but understanding how your plan works helps you make informed healthcare decisions.
Our team is available to answer general questions and provide guidance on billing or coverage requirements.
Understand Your Benefits
Understanding your insurance helps you make informed healthcare decisions and avoid unexpected costs.
By knowing your coverage, you can:
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Confirm which services are included
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Identify in-network providers, including MFM Health
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Anticipate copays, deductibles, and out-of-pocket expenses
While our team can answer general billing questions, patients are responsible for understanding their insurance benefits. This includes:
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Verifying coverage with your insurance provider
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Reviewing copays, deductibles, and cost limits
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Checking whether referrals or prior authorizations are required
Helpful Tips
Before scheduling an appointment, contact your insurance provider to confirm coverage and estimated costs.
Bring your most current insurance card to every visit at AllaraCare.
Take time to understand your plan details, including in-network providers and coverage limitations.
If you receive a new insurance card, please notify our team at your next visit so we can update your chart. You may also upload images of your new card through the patient portal.
If you have questions about billing or general insurance inquiries, our team is here to assist. However, to ensure the most accurate information, contacting your insurance company is the best first step.
In-Network Provider List
To help you in this process, we've provided links below to the major insurance company websites where you can easily access their find-a-provider look-up tools. These tools allow you to search for providers by name or location, making it simple to find our practice and the providers within it.
We Accept:
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Aetna
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Aetna Medicare Advantage
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Cigna
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Blue Cross
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Blue Benefit Administrators (Self-Funded)
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Blue Cross Medicare Advantage
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Fallon Medicare Advantage
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Fallon Senior Care Options
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Harvard Pilgrim
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Health Plans Inc. (Self-Funded)
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MassHealth PCC Plan
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Medicare
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MGB Health Plan (Commercial Only)
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Tufts Health Direct / ConnectorCare
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Tufts Medicare Preferred
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Tufts Health One Care
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Tufts Health Senior Care Options
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United Healthcare / UMR (Commercial Only)
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Wellpoint (formerly Unicare)
Not Accepted:
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Commonwealth Care Alliance
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MGB MassHealth ACO
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MGB Medicare Advantage
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MGB OneCare
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MGB Select HMO
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MGB Senior Care Options
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Tufts Health Together MCO
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Wellsense
Frequently Asked Questions
If you have questions about billing or general insurance inquiries, our team is here to assist. However, to ensure the most accurate information, contacting your insurance company is the best first step. Taking the time to understand your insurance benefits puts you in control of your healthcare journey.
Annual preventive exams are designed to focus on maintaining your health and are often covered by insurance at no cost to the patient. However, certain situations may lead to receiving a bill for services provided during your annual visit. Here’s why:
1. Additional Services Were Provided
If your provider addresses concerns beyond the scope of a preventive exam—such as diagnosing or managing a specific medical issue, prescribing medication, or ordering additional tests—these services are billed separately and may not be fully covered under your plan’s preventive care benefits.
2. Your Insurance Plan May Not Fully Cover Preventive Care
While most insurance plans cover annual exams, coverage can vary. Some plans may require cost-sharing, like copays or coinsurance, even for preventive services. Always check your insurance benefits to confirm your coverage.
3. Your Deductible Hasn't Been Met
Preventive services are typically exempt from deductibles. However, if additional services are provided that fall outside of routine preventive care, those charges may apply to your deductible, requiring you to pay out-of-pocket.
4. The Provider or Facility Was Out-of-Network
If you receive care from a provider or facility not included in your insurance network, you may be responsible for a portion of the charges. Verify that all providers involved in your care are in-network before your visit.
5. Coding or Billing Errors
Sometimes, services performed during your visit may be incorrectly classified. For example, a preventive service might be coded as diagnostic. If you believe your bill includes an error, contact our billing department to review the charges, and check with your insurance company to confirm how the visit was coded.
How to Avoid Unexpected Bills
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Understand Your Insurance Benefits: Review your plan’s details to know what’s included under preventive care.
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Communicate with Your Provider: Let your provider know you’d like to stay within the scope of a preventive visit. If additional concerns arise, ask if they can be addressed at a separate visit.
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Verify Provider Network Status: Ensure your provider and facility are in-network to avoid higher out-of-pocket costs.
If you’re unsure why you received a bill for your annual exam, review your Explanation of Benefits (EOB) from your insurance company and contact our billing office for assistance. We’re here to help you understand your charges and resolve any questions.
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Darci Finocchiaro: 1467862797
Joseph Shalhoub: 1598723637
Laura Andree: 1437837812
Leigh Nawoichik: 1629896154Many plans require a referral to see a specialist. Once you know the date and time of your specialist appointment, and the provider you are going to see, please fill out this Insurance Referral Form so we may process your insurance referral.
