Cost/Insurance

Insurance Information – Please Read Before Scheduling

Insurance coverage can vary widely depending on your specific plan and employer benefits, even if the insurance company name is the same. Because of this, it is your responsibility to verify that Pride Health Clinic and the specific provider you plan to see are in-network with your insurance plan before scheduling an appointment.

Important Things to Know

1. Verify Network Status
Please contact your insurance company to confirm:

• Pride Health Clinic is in network

• The specific provider you are scheduling with is in network
  Different plans under the same insurance company may have different networks.

2. Deductibles May Apply
Even if we accept your insurance, you may still be responsible for the full visit cost until your deductible is met.

3. Insurance Determines Your Balance
When we bill your insurance, they determine what portion you are responsible for. By law, we must bill you the amount they assign. In some cases, this amount may be higher than our discounted cash price.

4. Out-of-Network Responsibility
If Pride Health Clinic or your provider is not in your network, you will be responsible for the full visit charges. We cannot override insurance determinations or adjust charges based on network status.

5. Labs and Prescriptions
Even if we are out of network for your plan, your insurance may still cover lab work or medications. You may also submit claims for possible out-of-network reimbursement. Please ask us if you need a billing form.

Insurance Plans We Currently Contract With

Even if your insurance is listed below, you must still verify network status with your specific plan.

• Medicare

• Medicaid (Nebraska & Iowa)

• BlueCross BlueShield / Anthem

• Aetna / Meritain

• Midlands Choice / Cigna

• Medica (not CHI Medica)

• Amerigroup Iowa

• United Healthcare

• UMR

• Nebraska Total Care

• Iowa Total Care

• Molina (Nebraska & Iowa)

• Wellmark Iowa

• Tricare (Prime requires a referral from your PCP)

VA Benefits

VA benefits may be used only if the patient contacts the VA first to initiate a referral and contract with our clinic.
We are required to have the patient’s Social Security number on file to submit VA claims.