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Insurance Information

Premier Radiology and Borgess Health Alliance accept two types of Medicare Advantage plans; contracted plans and deemed (PFFS*) plans. The contracted plans require that the hospital or physician group have a contract with them to qualify them as "in-network." They usually don't pay for "out-of-network" services unless it is a true emergency. Deemed plans have the option of going to any facility or physician that participates with original Medicare as long as that facility/physician chooses to see them. Borgess Health Alliance chooses to see all PFFS plans. The PFFS plans listed below are the ones that we commonly see in the Kalamazoo area. The contracted plans listed below are the ones that Borgess Health and Premier Radiology are contracted with.

Medicare Advantage Plans

PFFS Plans (deemed) Pay Rate Bill to
BCBSM Medicare Advantage PFFS 100% Medicare P.O. Box 440 Southfield, MI 48037-0440
Humana Gold Choice PFFS 100% Medicare P.O. Box 14601 Lexington, KY 40512-4601
Medicare PLUS Blue PFFS 100% Medicare P.O. Box 440 Southfield, MI 48037-0440
Secure Horizons Direct (by Pacificare) 100% Medicare P.O. Box 659787 San Antonio, TX 78265-9787
Sterling Options I, II, III & IV PFFS 100% Medicare P.O. Box 69314 Harrisburg, PA 17106-9314
Today's Options PFFS (by Pyramid) 100% Medicare 4888 Central Drive, Houston, TX 78279-5180
Unicare Medicare Advantage PFFS 100% Medicare P.O. Box 795180 San Antonio, TX 78279-5180
WellCare PFFS 100% Medicare P.O. Box 4438 Scranton, PA 18505
Contracted Plans Pay Rate Bill to
BCN Advantage Per Contract Po. Box 38753 Grand Rapids, MI 49516
Great Lakes Personal Care Plus PPO Per Contract P.O. Box 2127 Southfield, MI 48037-2127
Humana Choice PPO Medicare Per Contract P.O. Box 14601 Lexington, KY 40512-4601
Priority Health Medicare Per Contract P.O. Box 853923 Richardson, TX 75085-3923
United Healthcare Medicare** Per Contract P.O. Box 659734 San Antonio, TX 78265-9734
Medicare Plus Blue PPO Per Contract P.O. Box 440 Southfield, MI 49037-0440

*Note: PFFS* means Private Fee For Service.
**United Healthcare Medicare contract includes Evercare and Erickson Advantage.

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1535 Gull Road, Suite 200, Kalamazoo, MI 49048 |
269.388.6350