Insurance Benefits Checker
Patient Relationship
*
Please Select
Self
Dependent
Insurance Carrier
*
Please Select
Aetna
Aetna Better Health of Virginia
BCBS PA BlueCard - Point of Service POS - Highmark
Beacon Health Strategies
Cenpatico Massachuetts
Centene
CENTENE ADVANTAGE PLANS
CIGNA
CIGNA Behavioral Health
DC BCBS
FirstCare
Harvard Pilgrim Health Care
Humana
Independence Blue Cross Blue Shield
MA BCBS
MD BCBS
Optima/Sentara Health Plan
OptumCare
PA BCBS - Highmark
Student Resources (UnitedHealthcare)
Tricare East Region
Tricare West Region
Tufts Health Plan
TX BCBS
UMR - Wausau
United Health Care
VA BCBS
Wellcare
WPS Tricare for Life
AccountKey
NPI
Today's Date
-
Year
-
Month
Day
Date
Patient's First Name
*
Patient's Last Name
*
Patient's Date of Birth
*
-
Year
-
Month
Day
Year-Month-Day
Patient's Gender
*
Please Select
Male
Female
Please note that while we recognize and respect diverse gender identities, this form requires you to select the gender assigned to you at birth due to insurance benefit check requirements. We appreciate your understanding and are committed to inclusivity in all other aspects of our services.
Policy Number
*
Policy Holder's First Name
*
Policy Holder's Last Name
*
Policy Holder's Date of Birth
*
-
Year
-
Month
Day
Year-Month-Day
Policy Holder's Gender
*
Please Select
Male
Female
Please note that while we recognize and respect diverse gender identities, this form requires you to select the gender assigned to you at birth due to insurance benefit check requirements. We appreciate your understanding and are committed to inclusivity in all other aspects of our services.
ins_sex
pat_sex
pat_rel
payerid
Email
example@example.com
Would you like to be contacted to schedule an appointment?
Yes
No
Are you a Human?
Submit
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