Medical Insurance Information

To ensure you maximize the benefits provided by your insurance company, we suggest you take the following steps:

New Patients

  • Call the member services number on your health insurance card:
    • Tell the insurance company the name of your child’s Essex Pediatrics doctor. If you have just had a baby, call your insurance company immediately to add your infant to your policy.
  • Ask the insurance company or your employer human resource department to review the terms of your insurance contract. Some insurance plans have large deductibles and little or no well child coverage. Ask your insurance carrier the following questions:
    • Do I have a deductible?
    • Is well child care covered by my insurance?
    • Are immunizations covered by my insurance?
    • How many checkups are covered per year?
    • What is my copay and is it required for all visits?
    • What is your policy for coverage for Emergency Room care?
  • Follow up with your insurance company 2 –3 weeks after you sign your contract or enroll a new child to your plan to verify they have correctly recorded your child’s new doctor.

Referrals to Specialists

  • If you belong to a managed care insurance company (HMO) and your child needs to see a specialist, you may need a referral from our office. Many referrals take 3 –5 days to process. Call Essex Pediatrics as soon as you plan to see a specialist, regardless of your appointment date with that physician.
  • Call the specialist a day or two before your appointment to verify the referral is in place. Lack of a referral from your primary care physician may result in nonpayment of claims or a decreased level of benefit from your insurance company.

Plan Participation

Essex Pediatrics participates in a variety of insurance plans. The list currently includes:

  • Blue Cross/Blue Shield
  • CBA
  • Cigna
  • First Health Networks
  • North American Preferred
  • Tricare
  • MVP
  • Vermont Managed Care
  • Fletcher Allen Preferred
  • VT Medicaid
  • United