Health insurance

Does Duke Medicine accept my health insurance plan? This is one of the most common questions we get asked by patients every day. The answer can have an important impact on the decisions you make regarding your care.

Duke Medicine contracts with most major health insurance plans and transplant networks. Before scheduling a hospital or clinic visit, it’s best to check with your health insurance plan to confirm your coverage.

Please call your insurance company and ask if you have access to health care services at Duke Medicine locations, and what (if any) copayments, coinsurances, and deductibles will be your responsibility. The Duke Consultation and Referral Center (888-275-3853) can also help you with insurance-related questions.

Medicare Advantage insurance plans

Please note that the list above is kept as current as possible, but information may change at any time without notice. 

For services typically covered by insurance, we bill your:

  • Primary insurance company
  • If applicable, your secondary insurance company
  • Medicare
  • Medicaid

Important items to remember:

  • Health insurance coverage varies and some services may not be covered.
  • If you have questions regarding your health insurance coverage, please call your insurance 
company to better understand how your policy works prior to receiving care at Duke.
  • Respond promptly to requests from your health plan for additional information. These requests 
must be handled before payment will be made by your health plan.

Health Insurance Marketplace Products

As you prepare to make decisions regarding health benefit coverage for 2015, we encourage you to select a plan that allows you continued access to the (quality care – world renowned care – add tagline) provided by Duke Medicine.   Selecting certain plans may require you to receive services from providers other than Duke Medicine. 

Duke Medicine is participating in the following health beneifit plans offered for 2015.  Enrollment in any of these plans will allow continued access to Duke Medicine:

  • Coventry One/Duke Medicine – all plans (the website does not currently list Coventry One’s Silver plans but will in coming days, so please check the website for updates)
  • BCBSNC – Blue Advantage
  • BCBSNC – Blue Select

Duke Medicine is NOT participating in the following plans. Selection of one of these plans would likely require you to pay significantly higher out-of-pocket costs to receive services from Duke Medicine doctors and hospitals.

  • BCBSNC – Blue Value
  • United Healthcare Compass

If you have already selected one of these plans, you can change your plan selection to a plan that includes Duke Medicine.  Any change in plans must be completed by February 15, 2015.  After that date, changes cannot be made until the next open enrollment period.