Accepted Insurance and Health Plans
If your card states there is “no network”, or it refers to “reference pricing”, please visit this page
The following list should be considered guidelines only as many insurers offer a wide variety of plan options that may determine, at the individual plan option level, whether or not a patient will be in network with Valley Health providers. Insured individuals should check with their employer’s benefits manager, broker, or plan manual to ensure they are accessing care through their plan option’s preferred providers to ensure they are receiving the highest benefit level. Insurers may require that patients use specific lab services – please check your card or plan manual to ensure you have lab benefits.
If you have any questions regarding your insurance plan’s participation status with Valley Health, please contact our Payer Contracting team at payercontracts@valleyhealthlink.com or 540-536-6140.
| Insurer | Plan |
|
Aetna
Machine Readable Files |
PPO |
| POS | |
| HMO | |
| Aetna Better Health Virginia (Managed Medicaid Plan) | |
| Aetna Better Health West Virginia (Managed Medicaid Plan) | |
| Aetna Medicare Advantage Plan | |
| Anthem and other Blue Cross plans | PPO |
| POS | |
| HMO (non-Anthem plans may not have benefits) | |
| Exchange plans (Virginia only; non-Anthem plans may not have benefits) | |
| Indemnity | |
| FEP | |
| Anthem Medicare Advantage | |
| Anthem HealthKeepers Plus (Managed Medicaid Plan) | |
| National Plans | |
| All others, contact your carrier | |
| CareSource | Exchange plans |
| Cigna | PPO |
| HMO | |
| EPO | |
| Exchange plans | |
| Great West | |
| Cigna Medicare Advantage (until 12/31/2025) | |
| Clear Spring Health | Medicare Advantage |
| Commercial/Private insurers utilizing the MultiPlan, PHCS, Virginia Health Network, and MedCost Networks. | Coverage varies by insurer and insurer’s plan options. Check with your employer’s benefits manager, broker, or plan manual to ensure they are accessing care through their plan option’s preferred providers to ensure they are receiving the highest benefit level |
|
Exchange Plans (sold through the ACA Marketplace Exchange) Virginia & West Virginia ONLY |
Anthem Healthkeepers Exchange |
| CareSource | |
| Cigna Connect | |
| Highmark West Virginia | |
| Sentara Health Plans | |
| United Healthcare | |
| First Health | First Health Network |
| Federal Employee Program (FEP) 2024 | Aetna Advantage Plan - Advantage |
| Aetna HealthFund CDHP and Aetna Value Plan (all options) | |
| Aetna HealthFund HDHP and Aetna Direct Plan (all options) | |
| APWU Health Plan - CDHP | |
| APWU Health Plan - High | |
| Blue Cross and Blue Shield Service Benefit Plan (all options) | |
| Compass Rose Health Plan (all options) | |
| Foreign Service Benefit Plan - High | |
| GEHA Benefit Plan (all options) | |
| GEHA Indemnity Benefit Plan (all options) | |
| M.D. IPA - High | |
| MHBP - Standard and Value (all options) | |
| MHBP Consumer Option - HDHP | |
| NALC (all options) | |
| Rural Carrier Benefit Plan | |
| SAMBA (all options) | |
| UnitedHealthcare Insurance Company, Inc. Choice HDHP | |
| UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO | |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced | |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | |
| HealthSmart | HPO |
| Highmark West Virginia | Exchange (West Virginia only) |
| PPO | |
| Indemnity | |
| West Virginia Medicaid | |
| Humana Medicare Advantage (no PFFS) | PPO |
| HMO | |
| Innovation Health | Innovation Health (Signature Partners) |
|
Medicaid Fee For Service (If assigned to a Managed Medicaid Plan – see below) |
Virginia Medicaid and West Virginia Medicaid Fee For Service Plans are accepted. If the insured has been assigned to a Medicaid Managed Care Plan, see “Managed Medicaid Plans” below. |
|
Managed Medicaid Plans Virginia & West Virginia ONLY |
Aetna Better Health Virginia |
| Aetna Better Health West Virginia | |
| Anthem HealthKeepers Plus | |
| Highmark West Virginia Options | |
| Molina Healthcare | |
| Sentara Health Community Plan | |
| The Health Plan of the Upper Ohio Valley | |
| Unicare West Virginia | |
| United Healthcare | |
|
Medicare A& B Fee For Service (If assigned to a Medicare Advantage Plan – see below) |
The Medicare A & B Fee For Service Plans are accepted. If the insured has been assigned to a Medicare Advantage Plan, see “Medicare Advantage Plans” below. |
|
Medicare Advantage Plans (no PFFS) |
Aetna Medicare Advantage |
| Anthem Medicare Advantage | |
| Cigna Medicare Advantage (through 12/31/2025) | |
| Clear Spring Health Medicare Advantage | |
| Highmark West Virginia Medicare Advantage | |
| Humana Medicare Advantage | |
| Innovation Health Medicare Advantage | |
| Molina Medicare Advantage | |
| Sentara Health Medicare Advantage | |
| United Healthcare Medicare Advantage | |
| Virginia Premier Medicare Advantage | |
| West Virginia Senior Advantage | |
| MedCost/Virginia Health Network | PPO |
| Ultra | |
| Multiplan/PHCS | Coverage varies by insurer and insurer’s plan options. Check with your employer’s benefits manager, broker, or plan manual to ensure they are accessing care through their plan option’s preferred providers to ensure they are receiving the highest benefit level |
| Peak Health | PPO |
| POS | |
| HMO | |
|
PEIA (UMR only) As of 7/31/2023, Valley Health will not accept PEIA through The Health Plan |
PEIA (UMR only)
As of 7/31/2023, Valley Health will not accept PEIA through The Health Plan |
| Sentara Health Plans | PPO |
| POS | |
| HMO | |
| Exchange (Virginia only) | |
| Sentara Medicare Advantage | |
| Sentara Community Plan (Managed Medicaid Plan) | |
| The Health Plan | PPO |
| POS | |
| HMO | |
| Medicaid | |
| Tricare |
Tricare
excludes Johns Hopkins US Family Health Plan, as it will not contract with Valley Health |
| Wellpoint West Virginia (formerly Unicare) | West Virginia Medicaid |
| United Healthcare | PPO |
| POS | |
| HMO | |
| Optimum Choice | |
| MDIPA | |
| OneNet PPO | |
| Options PPO | |
| Exchange (Virginia & West Virginia only) | |
| United Healthcare Medicare Advantage Plans | |
| United Healthcare Managed Medicaid Plan policies under Virginia Medicaid | |
| Valenz Access | Coverage varies by insurer and insurer’s plan options. Check with your employer’s benefits manager, broker, or plan manual to ensure they are accessing care through their plan option’s preferred providers to ensure they are receiving the highest benefit level |
| Virginia Medicaid (if assigned to a Medicaid Managed Plan – see above) | If the insured has been assigned to a Managed Medicaid Plan, see “Managed Medicaid” in the Insurer Column above. |
| Veterans Administration | Veterans Administration |
| Community Care Network | |
| West Virginia Welfare/West Virginia Medicaid (if assigned to a Managed Medicaid Plan – see above) | If the insured has been assigned to a Managed Medicaid Plan, see “Managed Medicaid” in the Insurer Column above. |
