INSURANCE & REIMBURSEMENT

Dr. Sloan-Garcia is contracted with traditional Medicare.  She is not contracted with any other insurance companies, and she does not participate in any insurance networks.  She is not contracted with any Senior, Advantage or Centennial plans. However, many insurance plans, do reimburse the member a percentage of out-of-network service fees after a deductible has been met. In fact, most of our patients receive at least partial reimbursement for our fees.  

  • If you have traditional Medicare 

    • We will file your insurance claims for you, and Medicare reimburses us directly for a large portion of the fee. 

    • For secondary claims, Medicare automatically forwards the claim to most secondary insurances.

    • Most secondary insurances pay the remainder due directly to us, but this is not guaranteed since Dr. Sloan is not contracted with commercial insurance companies.

    • If the secondary insurance does not reimburse us, then you are responsible for paying any balance due on the "Medicare allowable."  You are not responsible for any amount above the Medicare allowable.   

    • Labs, imaging and medications are covered according to your plans.

    • If you decide to become an on-going patient of Dr. Sloan's, there is a yearly $750 concierge/practice fee that is due 30 days after your initial consultation.  This fee is not covered by Medicare.

  • If you have a commercial PPO insurance with out-of-network benefits

    • Your insurance generally reimburses a portion of your bill after an out-of-network deductible which may be ​pricey.

    • When requested, an insurance superbill can be generated for you to submit to your insurance for reimbursement.  We help our patients file their claims, but we do not guarantee that your insurance will reimburse you.   

    • Labs, imaging & medications are covered according to your plan.

  • If you have insurance with only in-network benefits like an HMO

    • Your insurance will not cover your care with me. ​

    • You still may find my prices to be affordable.

    • When broken down monthly, you may find the cost of your care to be roughly equivalent to specialist copays.  

    • Labs, imaging & medications are covered according to your plan.

  • If you have a health spending account such as an HSA

    • Your HSA funds generally can be used to pay for your care. ​

    • My system generates the documents you may need to submit in order to use your HSA funds.  

    • If you are interested in using your HSA account to pay for your annual plan fee, please ask for additional information.

  • If you have Medicaid or a Medicaid Centennial plan

    • Because I am not in-network, Medicaid will NOT pay for services provided by me.

    • Because I am not in-network, Medicaid will NOT pay for any lab tests, imaging or medication ordered by me.​ 

    • Unfortunately, this means I no longer can provide care to a person with Medicaid even at a highly discounted price or for free.

  • If you do not have insurance

    • My annual plan options may be perfect.  

    • Self-pay discounts for labs, imaging and medications often are available.

  • What discounts do you offer?

    • U.S. military members and veterans without traditional Medicare receive 20% off the new patient consultation ONLY not the annual plans.