Insurance Information

Health Insurance Plans Accepted at NHOH

  • Anthem Blue Cross Blue Shield
  • Harvard Pilgrim
  • Tufts Health Plan
  • NH Medicaid:  NH Healthy Families and WellSense
  • Medicare
  • Champus/Tricare
  • United Healthcare
  • Cigna
  • Martins Point
  • PHCS Network Plans
  • HCVM/CCN/First Health Network Plans
  • Aetna
  • MVP
  • NH Insurance Exchange plans:  Anthem Pathways, Harvard Elevate, Maine Community Health Options, Minute Man and Assurant Health

Health Insurance Terms to Know

  • Co-Payment: a specific dollar amount the patient must pay to the institution or practice each time a service or office visit is requested. Co-payments are requested at the time of service, and are typically required as part of a policy as set by an insurance company (usually an HMO or PPO).
  • Deductible: the amount a patient is responsible for before insurance coverage takes effect.
  • Managed Care: a term describing programs designed to manage the quality and cost of health care. Preferably, managed care brings about a system where Patients receive the care they need, including preventative care, when they need it.
  • HMO (Health Maintenance Organization): these organizations provide insurance coverage, usually through an employee-based plan. HMOs rely on a primary care physician to manage a person’s care. There are certain restrictions on choice of physician, and types of specialty care that are covered, etc. Procedures and tests must have a pre-approval from the HMO to be covered under your plan.
  • Medicaid: a health insurance program for low or no income individuals and elderly patients. Many states have begun to introduce HMOs for this group of patients.
  • Medicare: A federal health insurance program for older and eligible disabled Americans.
  • Medical Necessity: a determination that a treatment, procedure, or test is necessary to a person’s health or treating an existing medical problem. For example, cosmetic procedures are not covered under medical necessity provisions.
  • Point of Service (POS): a managed care product where enrollees have a choice of different medical options when they need care. Patients are able to choose their own primary care physician outside of the network, but usually at a higher cost.
  • Pre-existing conditions (PEC): medical problems that an individual already has prior to acquiring an insurance plan. Preexisting conditions are not always covered by insurance policies.
  • Preferred Provider Organization (PPO): providers who will approve in-network and out-of-network benefits to patients without a PCP referral. The amount a patient will have to pay out of pocket is less when using an in-network provider.
  • Primary Care Physician (PCP): a physician whose practice is devoted to family/general practice, pediatrics, internal medicine, and occasionally obstetrics/gynecology

Please be prepared to present your insurance card at all visits to the office.  If you do have an insurance change and are currently receiving any treatment or prescriptions from our office, please call our office and inform them of your new coverage.  This may help prevent a delay in treatment or prescription refills, as many insurances require a prior authorization to be completed before approving a treatment or prescription refill.

If you have specific questions about your insurance plan or payment options, please feel free to call our office and ask to talk with our Patient Account Representative. They will be more than happy to answer any inquiries you may have.