Accepted Insurance Plans
We accept a wide variety of insurance providers to ensure that families have access to high-quality ENT care for their children. The following is a list of major insurance plans we accept:
This list ensures that most families in Tampa and surrounding areas can find coverage for their child’s ENT care. If your insurance is not listed here, please contact our office, and we will help verify coverage or explore alternative options.
Important Notes About Coverage
Understanding the specifics of your insurance plan is crucial for scheduling visits or procedures. Here are some key points to keep in mind:
Prior Authorization or Referrals
Some plans require approval or a referral from your primary care provider (PCP). For example:
- Blue Cross Blue Shield requires authorization through the Blue Shield Blue Cross Portal.
- United Healthcare Medicaid requires a referral via the UHC Web Portal.
- Tricare Prime requires a referral from your PCM.
Surgery Scheduling and Facility Requirements
Coverage for surgical procedures may vary depending on your insurance provider and whether out-of-network benefits apply. Examples include:
- Blue Shield Blue Cross Select: Covers all surgery centers.
- Blue Shield Blue Cross Anthem: Covers Tampa Bay Surgery Center if out-of-network benefits apply.
- Cigna Bay Care: Coverage limited to St. Joseph Children's Hospital.
- Aetna Advent Health: Coverage depends on the facility (Pediatric Surgery Center & Tampa Bay Surgery Center for YES Out-of-Network Benefits; HCA Florida Brandon Hospital & St. Joseph Children's Hospital for NO Out-of-Network Benefits).
Limitations and Exceptions
Certain plans may not cover specific services:
- No Pediatric Surgery Center coverage for Karin S. Hotchkiss, M.D., M.B.A., F.A.C.S. patients
- Cigna Auditory Processing Disorder testing is not covered
- Humana Medicaid is not accepted
We recommend contacting your insurance provider prior to your appointment to confirm coverage, co-pays, and any required authorizations to avoid unexpected costs.
Need Assistance? Contact Our Insurance Team
If you have any questions regarding your insurance coverage, required referrals, or prior authorizations, our team is here to assist you. We can help verify your benefits and guide you through the process.
We are committed to helping families navigate insurance and make accessing care as simple as possible.