A wealth of information about insurance.

ECU Health welcomes all patients, with or without insurance, and is contracted with most major insurance companies and some Medicare Advantage plans.

If the ECU Health hospital, facility or clinic where you are seeking care is not in network with your insurance company, it does not mean that you cannot receive care here. As a courtesy, we will send a bill to your insurance company. However, any amounts not paid by your insurance company will be your responsibility.

Patients with PPO, POS or EPO plans may use health care providers and hospitals outside of preferred networks (“out of network”), but you may incur higher out-of-pocket costs. Patients with HMO plans may be restricted only to in-network providers. Using providers outside of the HMO network could forfeit your coverage and place the entire financial burden on you. It is the patient’s responsibility to contact your insurance company to check benefits, coverage and financial responsibility.

Using Your Insurance with Our Providers and Facilities

You will encounter many commonly used insurance terms when you seek care. Click below to learn what they are and what they mean.

Your insurance card has many important pieces of information on it that help determine what is covered and what your financial responsibility is. While this information can vary depending on what your coverage is, most cards have some common information on it.

  • Subscriber name and Subscriber ID refers to who the primary insured person is, and the number that our office will need to file the claim.
    • This section may also show Member name and Member ID if your coverage includes others, such as family members.
  • Plan type: Many insurance payors are made up of different plans that include different coverage options. Let your clinic know what plan you see listed on your card.
  • Group numbers: Some cards may include group names or numbers. This information will be important to share with the clinic.
  • Date issued/Effective From: This date indicates how long you and any listed members have been covered under the insurance plan.
  • Copay/Deductible/Prescription cards: Most cards will have a section that includes what you can expect to pay at the doctor’s office. These fees can vary depending on if your visit is to an in-network or out-of-network provider, or if you are seeing a primary care doctor or a specialist.
  • Insurance Contact Information: This information is likely on the back of your card, and should include an address where we can mail your claim, as well as various phone numbers including Customer Service, that can help answer questions about your insurance.

When you’re enrolled in Medicare, you’ll get your Medicare card in the mail. If you’re automatically enrolled, you’ll get your Medicare card in the mail three (3) months before your 65th birthday or your 25th month of getting disability benefits. Your Medicare card shows that you have Medicare health insurance. It shows whether you have Part A (Hospital), Part B (Medical) or both, and it shows the date your coverage starts. Listed below in an example of the new Medicare card.

  • Name: Refers to who the insured person is (yourself only).
  • Medicare Number: Medicare Beneficiary Identifiers (MBIs), are unique and randomly generated. (Your new Medicare card will no longer have your Social Security Number (SSN) listed.)
  • Entitled: Indicates your level of coverage.
  • Coverage starts: This date indicates how long you have been covered under the insurance plan.
  • Insurance Contact Information: This information is likely on the back of your card and should include an address where we can mail your claim, as well as various phone numbers including Customer Service, that can help answer questions about your insurance.
  • Your card has a Medicare Number that’s unique to you, instead of your Social Security Number. This helps to protect your identity.
  • If you’re in a Medicare Advantage Plan (like an HMO or PPO), your Medicare Advantage Plan ID card is your main card for Medicare—you should keep and use it whenever you need care. And, if you have a Medicare drug plan, be sure to keep that card as well. Even if you use one of these other cards, you may also be asked to show your Medicare card, so keep it with you.

Insurance Contracts, Hospitals, Outpatient Facilities and Providers

ECU Health facilities and providers are contracted with most major commercial insurance companies and some Medicare Advantage plans. This list applies to ECU Health hospitals, outpatient facilities (including the ECU Health SurgiCenter), Outer Banks Professional Services, ECU Health Medical Group and ECU Health Medical Group Affiliates. Sometimes, contracts are facility-specific or vary across our geography. If you don’t see your insurance carrier listed, please check with your insurance company or the facility or physician that will be providing your care to verify coverage.

Inclusion of your insurer on the list does not guarantee coverage, however. You should always call the Customer Service phone number on your insurance card prior to scheduling a visit to confirm that the service you are seeking is covered and that the hospital or provider is in network.

The information provided on this list is subject to change and is reviewed and updated as needed. Every attempt is made to provide current, accurate information. Contact your insurance company with questions about your eligibility, benefits and/or coverage.

Nationwide Fee-for-Service Benefit Plans

(Open Only to Specific Groups)

  • Rural Carrier Benefit Plan Specific Areas
  • Foreign Service Benefit Plan Specific Areas
  • Compass Rose Health Plan Specific Areas
  • Panama Canal Area Benefit Plan Specific Areas
  • North Carolina Specific HMO, HDHP and CDHP Plans

North Carolina Specific HMO, HDHP and CDHP Plans

  • Aetna HealthFund All of North Carolina

Behavioral Health

Nationwide Fee-for-Service Benefit Plans

(Open to all Federal Employees and Postal Workers)

  • Blue Cross and Blue Shield Service Benefit Plan Nationwide
  • GEHA Benefit Plan Nationwide
  • NALC Nationwide
  • GEHA High Deductible Health Plan Nationwide
  • Mail Handlers Benefit Plan Value Nationwide
  • SAMBA Nationwide
  • Mail Handlers Benefit Plan Nationwide
  • APWU Health Plan Nationwide
  • Mail Handlers Benefit Plan Consumer Option Nationwide

Medicare Advantage Plans

  • Aetna Medicare Advantage
  • Blue Medicare
  • United Healthcare
  • Humana — It is anticipated that the ECU Health system will be out-of-network as of Jan. 1, 2024, with the following Humana Medicare Advantage products: PPO Medicare Advantage, POS Medicare Advantage, HMO Medicare Advantage and PFFS Medicare Advantage plans only.