Insurance, billing, and costs
Clear information about the health plans we accept and how you can pay for your child's care. We take most major commercial and Medicaid plans. A few plans we cannot take are listed plainly below - no surprises.
Plans we accept
Plans change often. Please check with your insurance company that we are in-network for your exact plan before your visit.
Commercial plans
- Aetna (not Aetna Medicaid)
- Adventist Health System Employee Health Plan
- Ambetter Health (marketplace plans)
- Avmed
- Blue Cross Blue Shield (not MyBlue or Blue Select)
- Cigna (not Cigna's BayCare-exclusive network)
- Humana (commercial)
- MultiPlan / PHCS (Primary Network only)
- Oscar Health
- UnitedHealthcare (not UHC Medicaid or UMR)
Medicaid plans
- Humana Medicaid
- Sunshine Health
Military plans
- TRICARE
Plans we cannot accept
We are out-of-network for these plans. If you have one, you would pay for the visit yourself at our self-pay price.
- Not accepted: ChampVA
- Not accepted: Cigna's BayCare-exclusive network (a Cigna carve-out - other Cigna plans ARE accepted)
- Not accepted: Aetna Medicaid
- Not accepted: UnitedHealthcare Medicaid & UMR
- Not accepted: Blue Cross MyBlue & Blue Select
We expect changes in late September 2026 when we join Privia Medical Group - including adding UnitedHealthcare Medicaid, Molina, and Cigna's BayCare network. Nothing is final yet. Call us to check on your plan.
Paying for your visit
No insurance? We welcome self-pay families. Every visit is one simple flat rate of $105, paid at the visit (non-refundable). No surprise bills, and vaccines cost nothing extra. This flat rate will change in late September 2026 when we join Privia Medical Group.
Vaccine costs. For most families, vaccines cost nothing extra. Kids with no insurance are covered by Florida's Vaccines for Children program at our office. One catch we cannot always see in advance: a few private plans do not fully cover vaccines. If that happens, the plan makes the family responsible for the cost, and by law we cannot use the free program for privately insured kids. If your plan is one of these, a federally qualified health center can give the shots at low or no cost - ask us and we will point you there.
Copays and deductibles. Your insurance sets amounts you pay at the visit. A copay is the flat fee for a visit. A deductible is the amount you pay before your insurance starts paying. For a sick visit, deductible amounts often run $65 to $120, depending on your plan. Please be ready to pay at the time of the visit.
Check before you come. Please make sure your plan is active, we are in-network, your child's primary care provider is set correctly, and no other policy is listed as primary on your account. This avoids surprise bills. We do accept secondary insurance.
New babies. Add your baby to your plan right away - most plans give you only 30 days. Our newborn care page walks you through every step, including Medicaid.
Bills and payments
Pay a bill online. Use our secure payment page. You will need the Statement Code printed on your statement.
Billing questions. The fastest way is a secure message through the patient portal. You can also call either office and choose the billing option.
Why did my "free" checkup have a copay?
A yearly well visit (checkup, shots, screenings) is preventive care. Most private plans cover it in full - no copay.
But if we also treat a separate problem at that visit - say allergies, or an ADHD medicine change - insurance counts that part as a sick visit, and your plan may charge its normal copay. The checkup part is still free; the extra care is not.
These rules come from federal law and your insurance contract, not from us. If a charge seems wrong, your insurance company is the right place to ask.
Card on file - how it works
At check-in, new patients (except Medicaid) provide a debit, credit, HSA, or FSA card, which we store securely.
After your visit, your insurance decides what you owe - the "Explanation of Benefits." We charge the card only that amount, so you never get chased by paper bills for amounts nobody knew at the visit.
Other fees
- FMLA forms: $60. Insurance cannot be billed for these, per the US Department of Labor.
- Immigration and IRS letters: $10.
Your rights against surprise medical bills
When you get care from our providers, federal law protects you from surprise billing. You have the right to a "Good Faith Estimate" that explains what your care will likely cost before your visit - just ask us.
Learn more at cms.gov/nosurprises.
Common insurance questions
What if I do not have insurance?
We welcome self-pay families. Every visit is one simple flat rate of $105, paid at the visit. There are no surprise bills, and vaccines never cost extra - we take part in Florida's Vaccines for Children program. This rate will change in late September 2026 when we join Privia Medical Group.
What should I bring to the visit?
Bring your child's insurance card (a photo on your phone works) and a photo ID. If your child is new to us, their shot records help too.
How do I add my new baby to my insurance?
Call your insurance soon after your baby is born - most plans give you only 30 days. For Medicaid, call (877) 711-3662 to activate coverage and pick us as the primary care provider.