Insurance & Billing

Shore Medical Center is dedicated to providing consumers with as much information as possible regarding potential healthcare costs. Accordingly, we have listed information on the insurers and products the hospital participates in as well as any exceptions.

This list may not be comprehensive. For example, specialty insurers such as workers' compensation and personal injury protection ("PIP") are not included because there are a number of different types of insurance products and we may not participate in all of them. If you do not see your plan listed on the website, we strongly recommend that you contact us or your health insurance plan to confirm whether your plan is in-network or out-of-network.

Plans In Which We Participate
Below is a list of the insurance plans in which Shore Medical Center participates. It is also important that you contact your insurance company prior to receiving services or care at Shore Medical Center. Each plan is different and some provide different levels of coverage that could make a difference in your out-of-pocket costs. It is always best to contact your insurance company to obtain more information.

In addition, the Physicians who provide care within our hospital might not participate in the same insurance plans as the hospital. You should check with the physician who is arranging your healthcare services to see which insurance plans the physician participates in. You should also know that these healthcare professional(s) costs are not included in the facility's charges. They will be billed separately by the physicians.

Accepted Insurance Carriers - Shore Medical Center
  • AETNA- All HMO, Medicare HMO, Indemnity, PPO, EP and POS product lines
  • AMERIHEALTH- All HMO, Medicare HMO, PPO and Indemnity product lines  
  • BEECH STREET/ MEDICHOICE- PPO product lines
  • CIGNA -HMO and PPO product lines
  • FIRST HEALTH- PPO product lines
  • FIRST MANAGED CARE OPTION- PPO product lines
  • HEALTH CARE PAYERS COALITION OF NJ- PPO product lines
  • HEALTHNET- (formerly known as PHS-Physicians Health Services) Traditional HMO product line
  • HORIZON BLUE CROSS- All HMO, Medicare HMO, PPO, Indemnity, No Fault and Worker’s Comp product lines
  • INDEPENDENCE BLUE CROSS (IBC)- PPO product
  • MEDICAID- Traditional plan
  • MEDICAID- Managed care HMO, Amerigroup UHC/Americhoice and horizon NJ Health. If you are a participant in any other Medicaid HMO product contact your member services department regarding coverage of services rendered at Shore Memorial Hospital.
  • MEDICARE- Traditional Plan
  • MULTIPLAN- PPO product
  • OXFORD- HMO product line
  • PHP OF NJ (Physician Health Plan)- PPO product
  • PHC (Principal Health Care) Delaware- HMO and PPO product lines
  • QUALCARE- HMO product line SIMCARE/ MEDIPLEX- PPO product
  • UNITED HEALTHCARE- PPO and Indemnity product lines
Participating Networks

These networks are identified on your insurance cards by their logo.  

  • COMMUNITY CARE NETWORK
  • CONSUMER HEALTH NETWORK
  • DEVON HEALTH SERVICES INC.
  • INTERGROUP PHCS (PRIVATE HEALTHCARE SYSTEMS)
  • PREMIER PREFERRED CARE

Please keep in mind that regardless of the type of insurance plan you have, you must comply with your carrier’s requirements.

Once you have been discharged, the hospital’s charges for services will be stated on a uniform bill. This bill pertains to the cost of services and supplies rendered during your stay, but does not include the professional services provided by private or hospital-based physicians.

While Shore Medical Center may be considered a participating provider (PAR) with your insurance carrier, the physicians who provide care within our hospital might not participate in the same insurance plans as the hospital. n addition. You should check with the physician who is arranging your healthcare services to see which insurance plans the physician participates in. This also applies to any service provided by an anesthesiologist, cardiologist, pathologist or radiologist. You should also know that these healthcare professional(s)' costs are not included in the facility's charges. They will be billed separately. Pre-certification is the patient's responsibility.

Physicians and Physicians Groups We Employ
Click here to see a list of the physicians or physician groups, and the insurance plans in which they participate, that are employed by Shore Medical Center. While the physicians are hospital employees, you may still receive a separate bill for their services in the event they process their own billing.

Physicians and Physicians Groups With Whom We Contract
Click here for a list of the physicians who have privileges at Shore Medical Center.

Below is a list of physician groups that are contracted with Shore Medical Center, and their participating insurances. They are not hospital employees but instead have a contract with the hospital to provide certain healthcare services that prevents us from using other physicians for these services. You should also know that these healthcare professionals' costs are never included in the facility's charges, they will bill you separately.

Emergency Room Physicians
  • Aetna
  • Amerihealth NJ
    • PPO
    • PPO HSA
    • EPO
    • EPO HAS
    • POS Plus
    • Amerihealth Advantage
    • Tier 1 Advantage
    • SHE EPO
  • Amerigroup
  • Americhoice
  • Horizon-All Products
  • Horizon NJ Health
Envision Anesthesiologist Group
  • Aetna
  • Amerihealth
  • BCBS
  • ChampVA
  • Cigna
  • Coventry (Processed thru Aetna)
  • Devon Health
  • GEHA (Processed thru Aetna)
  • EMBLEM/GHI (Processed thru Qualcare)
  • Great West
  • HCPC
  • Health Republic (Processed thru QualCare or MagnaCare)
  • HealthNet Americal
  • Horizon NJ BCBS
  • Horizon NJ Health
  • Independence BC/Keystone (Processed thru Amerihealth)
  • Local 825 (Processed thru MagnaCare)
  • MCPC
  • Medicaid NJ
  • Medicaid NY
  • Medicaid Managed Care
  • Medicare
  • Medicare Advantage
  • Medicare Replacements
  • NaphCare
  • National Health Quest
  • Optima
  • Optum Health
  • Oxford
  • PMCS/Multiplan
  • Qualcare
  • Tricare
  • UHC
  • UHC Community Plan
  • United Resource Network
  • University Health Plan
  • Watchtower
Penn Cardiologists/Interventional Cardiologists
  • AP/ELAP-EPO
  • Aetna-HMO,POS,PPO,Saving Plus, Student Health
  • Amerihealth (IBC)-
    • HMO
    • POS
    • PPO
  • Amerihealth Administrators (IBC)-
    • PPO
  • BCBC Association National Medicare Advantage PPO
    • PPO
  • Cigna-
    • EPO
    • HMO
    • POS
    • PPO
  • Devon Health-
    • PPO
  • Drexel University Student Health-
    • PPO
  • First Health (Includes First Health Global-contact PGM for Int’l Patients)-
    • HMO
    • POS
    • PPO
  • Geisinger Health Plan-
    • HMO
    • POS
    • PPO
  • Great-West Healthcare (Formerly One Health Plan)-
    • POS
    • PPO
  • Horizon BC/BS of NJ-
    • HMO
    • POS
    • PPO
  • Humana/Choicecare Network-
    • PPO
  • Independence Blue Cross (IBC)/Personal Choice-
    • HMO
    • POS
    • PPO
    • Workers Comp
  • Intergroup-
    • PPO
  • Keystone Autism Services
  • Keystone Health Plan East (Includes CHIP)-
    • HMO
    • POS
  • Multiplan-
    • PPO
  • Onenet PPO (Formerly Alliance)-
    • PPO
  • Oxford-
    • HMO
    • POS
    • PPO
  • Preferred Healthcare-
    • PPO
  • Premier Network (Devon Employee Group)-
    • PPO
  • Qualcare-
    • HMO
    • POS
    • PPO
    • Oscar Health Plans(EPO)
    • Workers Comp
  • Tricare (Health Net Federal Services)-
    • HMO
    • PPO
  • United Healthcare-
    • POS
    • PPO
  • Core Essential-
    • HMO/PPO
  • US Family Health Plan-
    • HMO
    • PPO
  • World Trade Center/HealthSmart-
    • PPO

Medicare Advantage Plans

  • Aetna HMO-
    • Basic
    • Choice
    • Premier
    • Standard Select
  • Aetna PPO
    • Gold
    • NJ Silver Regional
    • Standard
    • NJ Connect Gold
  • BCBS PPO-
    • Blue Cross Blue Shield Association
    • National Medicare Advantage
  • Cigna-HealthSpring-HMO-Preferred
    • Preferred Plus
    • Advantage
    • Preventive Care
  • Cigna-HealthSpring HMO SNP-
    • Total Care
    • Traditions
    • Achieve
  • Clover Health PPO-
    • Classic
    • Premier
    • Prestige
  • Coventry HMO-
    • Advantra Silver
  • Coventry PPO-
    • Advantra Gold
    • AdvantraOne
  • Gateway HMO SNP-
    • Assured Diamond, Ruby
  • Geisinger HMO-
    • Gold Classic Advantage
    • Gold Classic Complete
  • Gateway PPO-
    • Gold Preferred Advantage
    • Gold Preferred Complete
  • Health Partners HMO SNP-
    • Basic
    • Prime
    • Value
    • Special
  • Horizon BCBS (NJ) HMO-
    • Blue Patient-Centered
    • Blue Value
    • Blue Choice
  • Horizon BCBS (NJ) PPO-
    • Blue
    • NJ Direct 10
    • NJ Direct 15
  • Independence (IBC)PPO-
    • Personal Choice 65
  • Keystone Health Plan East (IBC)-
    • Keystone 65 Select
    • Preferred
    • Basic
  • Keystone First Health Plan HMO SNP-
    • Keystone First VIP Choice
  • PA Health & Wellness/Centene-
    • Allwell
  • United Healthcare (Excludes NJ-NJ residents will need to activate their Passport option to see PA providers)-
  • HMO-
    • AARP MedicareComplete,
  • Local PPO-
    • AARP MedicareComplete Choice
  • HMO-DSNP-
    • Dual Complete
    • Dual Complete ONE
  • PPO
    • UHC Assisted Living
    • UHC Nursing Home Plan 2
Advanced Radiology Solutions
  • Aetna
  • Amerigroup NJ
  • Amerihealth NJ
  • Cigna
  • Federal BCBS
  • Horizon BCBSNJ
  • Horizon NJ Health
  • Medicare
  • NJ Medicaid
  • Rail Road Medicare
  • Tricare
  • Clover Medicare
  • Oxford
  • Qualcare
  • United Healthcare
  • United Healthcare Community
  • Core Choice
  • Department of Labor
On-Site Neonatologist/Pediatrics
  • Aetna Better Health
  • Amerigroup
  • Amerihealth
  • Horizon BCBS and Affiliates
  • Horizon NJ Health
  • Multiplan
  • New Jersey Medicaid
  • OmniClaim
  • Qualcare
  • Wellcare of NJ
  • Pennsylvannia Medicaid
  • Preferred Health Care
  • Tricare
  • UHC Community Health
  • Omni Claim (Oxford Health Plan)
  • Peach State Health Plan
Cancer Center Radiation Therapy
  • Aetna
  • Aetna Better Health**
  • Amerihealth
  • Amerigroup
  • Cigna
  • Clover Health
  • Horizon BC/BS
  • Horizon NJ Health
  • Horizon Medicare Advantage
  • Magnacare
  • Molina Medicaid
  • Novitas
  • Oxford
  • Oscar (Qualcare)
  • United Healthcare Commercial
  • United Healthcare Community
  • Wellcare
  • RR Medicare (Palmetto GBA)**

**Please note that only Dr. Iyer participates in these insurances

Shore Cancer Center
  • Aetna
  • Amerihealth
  • Amerihealth Administrators
  • Amerigroup
  • Cigna
  • Clover
  • Horizon BC/BC-All Products
  • Horizon NJ Health
  • Horizon Medicare Advantage
  • Magnacare
  • Molina Medicaid
  • Novitas
  • Oxford
  • Qualcare
  • United Healthcare Commercial
  • United Healthcare Community
  • Multiplan
  • Tricare
  • Health Net
  • Humana
Maternal Fetal Medicine
  • Aetna
  • Amerigroup
  • Amerihealth
  • Cigna
  • Clover
  • Horizon BC/BS of NJ
  • Horizon NJ Health
  • Magnacare
  • Molina Medicaid
  • Novitas Medicare
  • Qualcare (Oscar)
  • Tricare/Humana Military
  • United Healthcare
  • Wellcare
  • RR Medicare (Palmetto)
Pathology
  • Aetna-HMO, PPO
  • Amerigroup
  • Amerihealth NJ
    • AH 65 HMO
    • AmeriHealth Advantage (EPO)
    • Community Advantage (EPO)
    • Local Value Network (EPO,PPO)
    • Local Value Network (HMO,HMO Plus, POS, POS Plus)
    • Regional Preferred (EPO, PPO)
    • Regional Preferred (HMO, HMO Plus, POS, POS Plus)
    • Tier 1 Advantage (EPO)
  • Cigna
    • Open Access Plus, OA Plus, ChoiceFund OA Plus
    • Open Access Plus, OA Plus, ChoiceFund OA Plus with CareLInk
    • PPO, Choice Fund PPO
    • HMO/Network-Cigna Healthcare of Southern New Jersey, Inc. HMO/Network
    • HMO/Network-Cigna Healthcare of New Jersey- Northern NJ HMO/Network
    • HMO/Network-Metro NY Seamless Network
  • Horizon
    • Horizon Advantage EPO
    • Horizon Direct Access
    • Horizon EPO/EPO Plus
    • Horizon HMO
    • Horizon Medicare Advantage PPO
    • Horizon Medicare Blue
    • Horizon Medicare Blue Choice
    • Horizon Medicare Blue Patient Centered
    • Horizon Medicare Blue Value
    • MyWay HRA/HSA Direct Access
    • Horizon POS
    • Horizon Patient Centered Adv EPO
    • NJ Direct
    • Omnia Plans All
  • Horizon NJ Health
  • Qualcare
    • HMO
    • POS
    • PPO
    • Workers Comp
  • Medicare
  • Medicare Rail Road
  • Medicaid
  • Tricare Standard
  • United Healthcare
Healogics Wound Care
  • Aetna
  • Amerihealth NJ
  • Cigna
  • Horizon
  • Horizon NJ Health

For Following Insurances please ask provider if they participate:

  • Amerigroup
  • Amerihealth
  • Oxford
  • United Healthcare
Persante Sleep Center
  • Aetna
  • Amerihealth NJ
  • Amerigroup*
  • Americhoice*
  • Cigna
  • Horizon**
  • Horizon NJ Health*
  • Oxford
  • United Healthcare

*Dr. Barnett does not participate

**Dr. Barnett participates in all Horizon products except Omni Tier 2

Kids First Harborview Pediatrics (Children’s Hospital of Philadelphia)
  • Aetna
    • CHOP Preferred Plan - CHOP Employees
    • CDHP - CHOP Employees
    • CDHP
    • Elect Choice
    • HMO
    • Managed Choice
    • Savings Plus/Managed Choice
    • Open Choice PPO
    • QPOS
    • US Access
    • Traditional Choice
    • Chickering Group
    • Signature Administrators
    • Meritain Health
    • GEHA
  • America's Choice Provider Network - PPO
  • AmeriGroup (NJ) - NJ Managed Medicaid/CHIP
  • AmeriHealth
    • HMO - CHOP Employees
    • NJ HMO
    • NJ HMO Health Exchange
    • NJ POS
    • NJ POS Health Exchange
    • NJ PPO
    • NJ EPO Health Exchange
  • AmeriHealth 65 - Managed Medicare
  • AmeriHealth Administrators - PPO
  • AtlantiCare - HMO/PPO
  • Blue Cross of NE PA (also known as First Priority Health) - NEPA Blue Care HMO
  • Blue Cross of NE PA
    • NEPA Indemnity - BlueCard Access
    • NEPA PPO - BlueCard Access
  • Blue Cross Blue Shield Federal
    • Basic - BlueCard Access
    • Standard - BlueCard Access
  • Blue Cross Blue Shield Out of Area - ALL PLANS - BlueCard Access
  • Capital Blue Cross
    • Indemnity - BlueCard Access
    • POS Plus - BlueCard Access
    • PPO - BlueCard Access
  • CHAMPVA - PPO
  • Cigna Health Plans
    • HMO
    • PPO
  • CoreSource - Lancaster General Hospital - PPO
  • Coventry Healthcare
    • HMO
    • HMO Open Access
    • POS
    • PPO
  • Devon Health Services - PPO
  • Employers Health Network - PPO
  • Empire Blue Cross Blue Shield
    • EMP - PPO - BlueCard Access
    • EMP - DIRECT POS - BlueCard Access
    • EMP - DIRECT SHARE POS - BlueCard Access
    • EMP - TOTAL BLUE HRA/HSA - BlueCard Access
  • First Health - ALL PLANS
  • Gateway Health Plan - PA Managed Medicaid
  • Geisinger Health Plan 
    • HMO
    • PPO
    • POS
  • Golden Rule Insurance Plan - UHC Product Line
  • Great West (CIGNA) - Open Access POS
  • Harvard Pilgrim (UHC Choice Plus Network for PA and NJ) - PPO
  • HealthPartners of MN (affiliation with Cigna) - Commercial plan
  • H.E.R.E.I.U Welfare Fund - LOCAL 54
  • Highmark Blue Cross Blue Shield
    • EPO (PA - Yes - NJ - BlueCard Access)
    • PPO (PA - Yes - NJ - BlueCard Access)
    • Indemnity (PA - Yes - NJ - BlueCard Access)
    • Others (PA - Yes - NJ - BlueCard Access)
  • Highmark Blue Cross Blue Shield - Keystone Blue HMO KHPE West
  • Highmark Health Options - DE Managed Medicaid
  • Horizon Blue Cross Blue Shield of NJ - ALL PLANS
  • Horizon NJ Plus - NJ Plus - POS
  • Humana ChoiceCare - ALL PLANS
  • Independence Administrator - PPO - Y**
  • Intergroup - Preferred & Select Plans (includes Beech Street)
  • Keystone Health Plan Central- PPO - BlueCard Access
  • Keystone Health Plan East - HMO - Y**
  • Keystone Health Plan East - PA Kids PA CHIP
  • Keystone Health Plan East - POS
  • Keystone 65 Managed Medicare
  • LifeTrac - TRANSPLANT SERVICES
  • Mail Handlers Benefit Plan 
  • MAMSI Life & Health - UHC Product Line
  • Medical Assistance of NJ - State MA Plan
  • NJ Carpenters Fund - Horizon BC/BS
  • OneNet (Alliance) - UHC Product Line
  • Oxford - UHC Product Line
  • Personal Choice PPO, PHO - Y**
  • Personal Choice - PennCare (employees of UPHS; HUP, Pennyslvania Hospital, Chester County Hospital, and Presbyterian Hospital) Y, Tier 1
  • Populytics (Valley Preferred)  - PPO
  • Preferred Care  - PPO
  • Preferred Healthcare/PPHN (Pennsylvania's Preferred Health Networks) - PPO
  • Private Health Care Systems (PHCS) - PPO
  • Qualcare - All Plans
  • Qualcare - Oscar Insurance Company
  • Tricare - East Humana Military Services
  • Tricare - Overseas International SOS
  • UnitedHealthcare  - ALL PLANS (except Empire Plan)
  • UnitedHealthcare  - Empire Plan (NY State Employee Plan)
  • UnitedHealthcare - UHC Compass
  • UnitedHealthcare - UMR
  • UnitedHealthcare Community Plan PA FAMILIES (MA) - PA Managed Medicaid
  • UnitedHealthcare Community Plan PA KIDS (CHIP) - PA CHIP
  • UnitedHealthcare Community Plan NJ - NJ Managed Medicaid/CHIP
  • Optum Health (formerly URN) - Direct
  • Optum Health (formerly URN) - CHOP
  • UPMC for You - PA Managed Medicaid
  • UPMC Commercial - Commercial plan
  • US Family Services/St Vincent Medical Centers - Military Health Services

**SUBJECT TO CHANGE