AETNA
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
Aetna
HMO
|
Aetna Health Network
Option
HMO Based
Product with
POS Option
|
Aetna
Golden Medicare
|
Aetna
Open Choice
|
Aetna
Golden Medicare
Plan
(HMO)
|
|
Aetna
Open Access
HMO
|
Aetna
Select POS
|
|
Aetna
Affordable
Health Choice (Indemnity Plan)
|
Aetna
Golden
Medicare
Open Access
(HMO Plan)
|
|
Aetna
Open Access
Managed
Choice
(HMO)
|
Aetna
Managed
Choice
POS
|
Aetna
Golden
Choice Plan
(PPO)
|
Aetna
Traditional
Choice
(Indemnity Plan)
|
|
|
Aetna
Elect Choice
EPO
(HMO)
(Based Product)
|
Aetna
Quality
Point-Of Service (QPOS)
|
Aetna
Affordable
Health
Choice
(PPO)
|
|
|
|
Aetna
Health
Network
Only
HMO
Based Product (network only)
|
Aetna
Open Access
Elect Choice
(POS)
|
|
|
|
|
| |
Aetna
Open
Access Select
(POS)
|
|
|
|
No
Medicaid Product
|
| |
Aetna
Choice
(POS)
|
|
|
|
|
|
Aetna
Choice
(POS II)
|
|
|
|
|
|
AMERIGROUP
|
Managed Care/HMO
|
Managed Care/ POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
|
|
|
|
|
NJ
Family Care
A
|
|
|
|
|
|
NJ
Family Care
B
|
|
|
|
|
|
NJ
Family Care
C
|
| |
|
|
|
|
|
AMERIHEALTH
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
AmeriHealth
HMO Plus
|
AmeriHealth
POS Plus
|
AmeriHealth
Personal Choice
|
|
AmeriHealth 65 Medicare
HMO
(Complete) Medicare Replace
Product
|
|
**SEE NOTE LISTED BELOW **
|
AMERICHOICE
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
|
|
Americhoice Medicare
|
Americhoice Medicaid
Product
|
| |
|
|
|
|
Americhoice
NJ
Family Care
|
**SEE NOTE LISTED BELOW**
|
CIGNA HEALTHCARE
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
Cigna
HMO
Network
|
POS
Network POS
|
PPO Plus
|
Indemnity
|
|
|
HMO
Open Access Network
Open Access
|
POS
Open Access
Network POS Open Access
|
EPO Plan
|
Cigna
Choice
Fund Plan
|
|
|
Network
Point
of Service
|
Open
Access Plus
|
Fundamental Care
|
|
|
|
| |
|
Star Bridge
|
|
|
|
| |
|
Strategic Alliances
|
|
|
|
| |
|
Shared Administration
|
|
|
|
| |
|
|
|
|
|
HORIZON BLUE CROSS &
BLUE SHIELD OF NEW JERSEY
|
Managed Care
HMO
|
Managed
Care
POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
Horizon
HMO Prefix: YHM
|
Blue Card
POS
Prefix : Varies
|
Federal Employee Program (FEP)
|
|
Horizon
Medicare Blue Value Prefix:
YHT, YHV
|
|
Horizon
HMO
Access
Prefix: YHM
|
Horizon POS
|
Blue Card PPO
|
|
Horizon
Medicare Blue Solutions
Prefix: YHV, YHT
|
|
Horizon
Direct Access
|
Horizon
NJ Plus
|
Horizon
PPO
|
|
|
|
| |
|
Horizon
High
Deductibles
PPO
Plan D
|
|
|
|
| |
|
Horizon
MSA PPO
Plan D
|
|
|
|
| |
|
HHP
No Utilization Management
Related Questions
May Be Directed
To: 1-800-664-8183
|
|
|
|
|
EMPIRE BLUE CROSS/BLUE SHIELD
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
HMO Prefix: YLN, YLT
|
Direct POS
In-Network Provider
Out- of Network Member Prefix:
YLF
|
PPO/EPO
Prefix: YLB, YLD
|
|
Senior Plan Direct (HMO)
|
|
Direct
HMO
Prefix: YLN, YLT
|
Direct Share POS In-Network Provider
Out-of -Network Member Prefix: YLF
|
PPO/EPO
Prefix: YLE, YLK
|
|
Senior
Plan Direct Plus
|
|
Direct Pay
HMO
Prefix: YLN, YLT HMO Offered to
Individuals Who are not Members
Prefix : YLF
|
Direct Share HMO/POS
offered to individuals who are not member of an Employer Group Limited
Benefits Prefix: YLN
|
Empire
Total Blue Prefix:
YLD
|
|
Senior
Plan Direct
PPO Plan Plus
|
|
Child Health Plus State-Subsidized HMO Plan
and Benefit Package for Uninsured Children Living in NY State Prefix: YLN
|
|
|
|
|
|
Healthy New York State-Subsidized HMO Plan
and benefit package for low-income employed individuals and small business
in NY State Prefix: YLN
|
|
|
|
|
|
|
HEALTHNET (Formerly
Physician Health Plan & First Option)
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
Health Net
Charter II
|
|
|
|
Health Net
Medicare
Advantage
|
Health Net
Healthy
Options NJ
|
| |
|
|
|
|
New Jersey
Family Care
Plan A
|
| |
|
|
|
|
New Jersey
Family Care
Plan B
|
| |
|
|
|
|
New Jersey
Family Care
Plan C
|
| |
|
|
|
|
New Jersey
Family Care
Plan D
|
| |
|
|
|
|
|
**See Note Listed
Below Regarding Changes For Health Net**.
|
OXFORD HEALTH PLAN
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
Oxford
Health Plan (HMO)
|
Oxford
Health Plans POS
|
|
|
Oxford
Medicare Advantage
|
|
Oxford HP Freedom (HMO)
|
Oxford Liberty POS
|
|
|
Oxford Health
Plans
New York
Medicare Balance
|
|
Oxford Health Plans (HMO) Select Liberty
|
|
|
|
Oxford Health
Plans
New York
Medicare
Signature
|
|
Oxford Health Plans Select
|
|
|
|
Oxford
Health
Plans New York Medicare
Mosaic
|
|
Oxford
Health Plans
Liberty
Plan Select
|
|
|
|
|
|
Oxford Health Plans
New York Freedom Plan
|
|
|
|
|
|
Oxford
Health Plans
New York Liberty Plan
|
|
|
|
|
|
|
QUALCARE
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
Qualcare
HMO
|
Qualcare
POS
|
Qualcare
PPO
|
|
|
|
|
UNIVERSITY HEALTH PLAN
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
|
|
|
Medicaid HMO
|
| |
|
|
|
|
NJ Family Care Plan A
|
| |
|
|
|
|
NJ Family Care Plan B
|
| |
|
|
|
|
NJ Family Care Plan C
|
| |
|
|
|
|
NJ Family Care Plan D
|
| |
|
|
|
|
|
**See Note Listed Below Regarding
Changes**
|
UNITED HEALTHCARE
|
Managed Care
HMO
|
Managed Care/ POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
United
Healthcare
Select
&
Choice Plan
|
United Healthcare Medicare
Complete Choice
(PPO)
|
United
HealthCare Indemnity
Plan
|
United HealthCare Medicare
Complete
(HMO)
|
|
| |
United
HealthCare
Select Plus
&
Choice
(Plus Plan)
|
United HealthCare Medicare
Select (Supplement)
|
United
HealthCare
Basics Plan
|
|
|
|
AMERITAS
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Ameritas
Managed Care
PPO
|
Ameritas
Traditional
|
|
|
|
ATLANTICARE HEALTH PLAN
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
AtlantiCare
Health Services
|
|
|
|
| |
|
AtlantiCare
Health Plan
|
|
|
|
|
BEECH STREET CORPORATION
|
Managed Care
HMO
|
Managed Care/POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Beech Street
Corp
PPO
|
|
|
|
|
CONSUMER HEALTH NETWORK
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Consumer Health Network
|
|
|
|
|
CORRECTIONAL MEDICAL
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
CMS
Correctional
Medical Services
(PPO)
|
|
|
|
|
DENTAL ALLIANCE
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Dental
Health Alliance
DHA
PPO
|
|
|
|
|
Express Scripts Inc.
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Express Scripts , Inc. (Prescriptions Express)
|
|
|
|
|
FAMILY CHOICE HEALTH
ALLIANCE
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Family Health
|
|
|
|
|
FORMOST
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
ForMost
|
|
|
|
| |
|
|
|
|
|
GUARDIAN RESOURCES, INC.
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Guardian
Resources Inc.
|
|
|
|
| |
|
|
|
|
|
HEALTH NETWORK, INC.
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Health Network,
Inc.
|
|
|
|
| |
|
|
|
|
|
HEALTH PAYORS ORG. LTD
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Healthsource
NY/NJ
|
|
|
|
| |
|
|
|
|
|
INS. DENTISTS OF AMERICA
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Insurance
Dentists of America
|
|
|
|
|
INTERGROUP SERVICES
CORPORATION
|
Managed Care
HMO
|
Managed Care/ POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Intergroup
Services Corporation
|
|
|
|
|
MAGNACARE NETWORK
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
MagnaCare
Network PPO
|
|
|
|
| |
MEDICHOICE
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Medichoice
|
|
|
|
|
METLIFE PREFERRED DENTAL
|
Managed Care
HMO
|
Managed Care
POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Met Life
Preferred
Dental Program
(PDP)
|
|
|
|
|
MULTIPLAN
|
Managed Care/HMO
|
Managed Care/ POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Multiplan, Inc.
|
|
|
|
| |
|
|
|
|
|
OXFORD HEALTH PLAN
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Oxford
Health Plan
(PPO)
|
|
|
|
|
PRIVATE HEALTHCARE SYSTEM
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| | |
Private
Healthcare System
Inc.
|
|
|
|
| |
QUALCARE
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
QUALCARE
(HMO)
| |
QUALCARE
(PPO)
|
|
|
|
|
SUPER VISION SERVICES
|
Managed Care
HMO
|
Managed Care POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
Super
Vision
Services Inc.
|
|
|
|
|
UNITED HEALTHCARE
|
Managed Care/HMO
|
Managed Care/ POS
|
PPO
|
Traditional Indemnity
|
Managed
Medicare
|
Medicaid HMO
|
| |
|
United
Healthcare
(PPO)
|
|
|
|
| |
UNITED PAYORS
|
Managed Care/
HMO
|
Managed Care POS
|
PPO
|
Traditional
Indemnity
|
Managed
Medicare
|
Medicaid
HMO
|
| |
|
United
Payers & Prov.
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
