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What insurance plans is Circle Medical in-network with?

In-network with most major insurance plans. Your insurance plan can still be out of network.

Circle Medical is in-network with most major insurance plans, including the insurance below. Being in-network with that insurance does not mean your insurance plan is in-network. Check your insurance before you book.

When you book and want to use insurance, we check your plan and match you with an in-network provider who is licensed in your state and can offer the care you need. See How to find an in-network provider.

If Circle Medical is in-network, you may still have a copay, deductible, or coinsurance. Ask your insurance if a video appointment is covered. You can get a free cost estimate before you book, and you may also see one while you book. The estimate is not your final invoice. See Understanding your insurance benefits and what you might owe.

If Circle Medical is out of network

You can book and self-pay. See Appointment costs.

This does not apply if you are eligible for Medicaid. See Does Circle Medical accept Medicaid?

Self-pay means you choose to pay Circle Medical directly for the appointment, instead of having us bill your insurance. You are responsible for that charge.

We do not bill your insurance for a self-pay appointment. After the appointment is paid, you can ask for an itemized bill and submit it to your insurance yourself. Your plan decides whether to pay you back. See How to get an itemized bill (superbill) for reimbursement.

Being out of network does not always mean your insurance pays nothing. Some plans cover out-of-network care, usually at a higher cost to you.

Insurance we are commonly in-network with

In-network with most insurance plans from:

  • Aetna

  • Anthem Blue Cross

  • Blue Cross Blue Shield

  • Blue Shield of California

  • Cigna

  • UnitedHealthcare

You can see all the insurances we accept when you book, or when you add your insurance on the web portal or mobile app. See How to add, update, or remove your insurance.

PPO, EPO, POS, and HMO plans

The type of insurance on your card does not, by itself, mean Circle Medical is in-network.

PPO. A PPO from the insurance above can still be out of network. Your insurance may not cover this appointment at the same rate, which could mean higher out-of-pocket costs.

EPO. An EPO usually covers only in-network providers, except in an emergency. If Circle Medical is out of network with your EPO, your insurance will likely not pay for the appointment, and may not reimburse you if you self-pay. Some EPOs also need a referral. Check your insurance.

POS. A point-of-service (POS) plan usually needs a referral from your primary care provider before it covers care. Some POS plans cover out-of-network care at a higher cost. Check your insurance.

HMO. Circle Medical may be able to send a claim to an HMO. Your insurance usually needs an approved referral from your assigned primary care provider first. You do not need that referral if a Circle Medical provider is already your assigned primary care provider, or if your insurance does not require a referral. See How to get your HMO referral or student health plan authorization.

Third party administrators (TPAs)

Your insurance may use a third-party administrator (TPA), like Meritain Health, to manage your benefits. This is most common with insurance from an employer, when the employer pays for your care and a TPA manages the benefits. The TPA can send your card, handle claims, and answer questions about your coverage. The TPA is not always the network.

The network is the group of providers your insurance treats as in-network. That name can be different from the TPA, and it may be a logo or a smaller line on the card, such as Aetna, Cigna, UnitedHealthcare, or Blue Cross Blue Shield.

Check the card for both names. Use the network name to see if Circle Medical is in-network. If you cannot tell which name is the network, call the number on the card and ask which network your insurance uses. Your insurance can still be out of network even when that network is on this list.

Student health insurance

Student health insurance may show a familiar name, such as Aetna or UnitedHealthcare, and still cover only the campus health center.

Many student health plans need an authorization before Circle Medical can bill a visit. Your plan may call this an authorization or a referral, and it often starts at your campus student health center. Circle Medical cannot request it for you. Some plans do not require one, for example when you are far from campus, during school breaks, or for mental health care.

If you do not want to wait, you can book and self-pay. We will not bill your student health plan for that visit, and your plan may not pay you back.

How to check your insurance is in-network

Use the insurance page to find your provider's NPI and tax ID. Give those numbers to your insurance when you ask if Circle Medical is in-network.

When you book, we'll ask for your insurance information and match you with an in-network provider. See How to find an in-network provider and How to add, update, or remove your insurance.

Some insurance requires you to select a Circle Medical provider as your primary care provider before your insurance will cover the appointment.

Medicare

Circle Medical accepts Medicare in some states. See Does Circle Medical accept Medicare?

Medicaid

Unfortunately, we're unable to see patients who are eligible for Medicaid, even if you'd prefer to self-pay or have other insurance. A card that says Aetna, Blue Cross Blue Shield, or UnitedHealthcare can still be Medicaid. See Does Circle Medical accept Medicaid?

Veterans and military insurance

TRICARE is insurance for uniformed service members, retirees, and their families. VA health care is care for an eligible veteran, usually at a VA clinic or hospital. CHAMPVA helps pay for civilian care for some family members of a veteran. It is not for the veteran, and it is not TRICARE.

TRICARE. We accept TRICARE in select states.

In states where we accept TRICARE, we bill TRICARE for your appointment. You cannot choose to self-pay for a covered visit with a provider who is in network with TRICARE.

If there are no TRICARE in-network providers in your state, you can book and self-pay. See Appointment costs.

VA health care. VA health care is not insurance. For VA to pay for care outside a VA clinic, you need a referral and approval from your VA care team through VA Community Care before the appointment. Without that approval, VA will not pay for the appointment. You can book and self-pay, or use other insurance you have. See Appointment costs.

CHAMPVA. We do not bill CHAMPVA. CHAMPVA does not have a provider network. You can pay for the appointment, ask us for an itemized bill, and then file a claim with CHAMPVA. CHAMPVA pays back a portion of its allowed amount, and you must file within 1 year of the appointment. See How to get an itemized bill (superbill) for reimbursement.

Kaiser Permanente

We don't accept Kaiser Permanente. You can book and self-pay. See Appointment costs.

Some Kaiser Permanente cards show a Cigna logo. That lets you get urgent or emergency care from Cigna providers when you travel to a state without Kaiser Permanente. It does not cover routine or primary care, and it does not make Circle Medical in-network for your regular appointments.

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