Insurance & Medicare
Accepted Insurance Providers
UP Health System is an approved healthcare provider and has contracted with many insurance companies to bring you the best care while being convenient to you and your health insurance company.
Most plans cover wellness exams and screenings. If you have questions about what your plan covers, call the number on the back of your insurance card.
We participate as a preferred provider with these organizations:
Aetna
Blue Care Network
Blue Cross Blue Shield of Michigan
CIGNA
Cofinity
Great West (formerly ONE HEALTH)
HAP
Health EOS
Humana Medicare Advantage
Medical Access Program - Adult Benefit Waiver
Medicare
Medicare Blue (Medicare Advantage)
Medicaid
MIChild
MultiPlan/PHCS
Priority Health
Tricare
UMR/Fiserv
United Healthcare
UPHP Medicaid
UPHP Medicare
UPHP Plus Medicare Special Needs Plan
WEA
As a courtesy, we will bill all insurances. However, we cannot guarantee payment. Insurances listed above are the insurances we have a participating agreement with.
For more information, please call our Business Services Department at 906.449.1422.
Medicare
Medicare coverage can be a confusing and complicated subject to the very people it covers. Our billing staff is always here to help. But we have learned that one of the most helpful tools in understanding your coverage is the Medicare website. The Medicare website offers a wealth of up-to-date information depending on your situation and location. It's often the place we go to get information for you.
What is Provider-Based Billing (PBB)?
PBB refers to the billing process for services rendered in a hospital department or location. This process takes place when the hospital owns space and employs physicians and other support personnel who are involved in patient care.
This benefits patients as all departments of the hospital are subject to rigorous quality standards and are monitored by The Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 17,000 healthcare organizations and programs in the United States.
The Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.
Will there be a change in how patients receive care?
No. Patients will continue to receive excellent quality care with their physician and scheduling appointments and tests will be handled as they always have been in the past. However, there is a change in how UP Health System will bill your insurance carrier for these services.
How does this affect the billing process?
Because care is provided in a department of the hospital, patients may receive a bill from UP Health System - Portage Hospital as well as a separate bill from UP Health System - Portage Medical Group for the professional services provided by their physician. In addition, physicians who interpret the results of diagnostic tests may send you a bill from Superior View Radiology.
Medicare beneficiaries are responsible for the co-insurance amount on the services you receive. These amounts are determined by Medicare and are based on the services performed.
Will Medicare patients have to pay more for services?
Medicare patients without supplemental insurance may have to pay a small amount. Medicare patients with supplemental insurance should check with the insurance provider prior to care to see if the service will be covered. Patients with other health insurance should check with their insurance provider and ask whether it covers facility charges or Provider-Based Billing. Depending on specific insurance benefits, additional out-of-pocket expenses may be incurred by Provider-Based Billing.