Insurance Guide

Dickson Medical Associates (DMA) accepts most major ‘managed care’ insurance plans (HMOs, PPOs & Medicare). If DMA is contracted with your current health plan, we will bill your insurance on your behalf. Your plan may require copayments and deductibles that are required by your health plan, and are to be paid when you check-in for service. We must have your current and accurate information in order to submit claims to your insurance company. Please remember to always bring your insurance card so that we may verify your insurance at check-in prior to each visit.

Benefits vary from plan to plan. Some visits, procedures or tests, may not be covered by your insurance. Balances not paid by your insurance are your responsibility and will be billed to you on a monthly statement. Please contact your insurance company for benefit specific questions including coverage, participation, referral information, restrictions, deductible status and co-pay requirements.


Types of Insurance:

HMO:
An HMO is a Health Maintenance Organization. When you join an HMO, you will be asked to choose a primary care physician (PCP). Your PCP will take care of your routine healthcare needs and coordinate any necessary specialty care. Before you can see a specialist, your PCP will request an authorization for a specialty referral based on your health plan’s guidelines.

PPO:
A PPO is a Preferred Provider Organization. When you join a PPO, you will have a choice of providers to seek care from within the PPO network. You will typically have a deductible and/or copay if you go to a provider within the network.

A PPO negotiates arrangements with a network of doctors, hospitals and other providers who accept lower fees from the insurer for their services. If you choose to go to a physician or hospital outside your PPO network you will have much higher out-of-pocket expenses.

If you are covered by one of our contracted PPOs, DMA will bill your carrier for services rendered, so you do not have to complete claim forms.

Medicare
Medicare Part B is the medical insurance portion of Medicare, which covers physician services, outpatient hospital care, and many other services typically covered under health insurance plans. Part B is financed through monthly premiums paid by enrollees and by contributions from the federal government.

If you are covered by Medicare Part B, DMA will bill Medicare for services rendered, so you do not have to complete claim forms.

DMA also accepts many Medicare plans including Medicare Advantage plans that cover the costs of many services not covered by straight Medicare.

Learn more about Managed Care Insurance plans and Medicare and Medicare Advantage Plans accepted by DMA.