Accepted Health Insurance Plans

Short Overview

Duke Health contracts with most major health insurance carriers and transplant networks. Please call your insurance company and ask if you have access to health care services at Duke Health locations, and what (if any) co-payments, co-insurances, and deductibles will be your responsibility. The Duke Consultation and Referral Center (855-855-6484) can also review the list of Duke Health accepted insurance plans with you. 

This list covers insurance plans accepted by Duke Health in 2022. It is not all-inclusive, is updated periodically, and may be subject to change.

Accepted Health Insurance Plans

Paragraph(s)

Aetna 

  • Aetna Choice POS, Aetna Choice POS II
  • Aetna Elect Choice HMO, Aetna Open Access Elect Choice
  • Aetna Health Network Only, Aetna Health Network Option
  • Aetna HMO
  • Aetna Limited Benefit Insurance PPO
  • Aetna Managed Choice POS
  • Aetna Medicare Value Plan (HMO)
  • Aetna Medicare Assure Plan (HMO D-SNP) 
  • Aetna Medicare Eagle Plan (PPO)
  • Aetna Medicare Essential Plan (PPO)
  • Aetna Open Access HMO, Open Access Aetna Select, Aetna Open Access Managed Choice
  • Aetna Open Choice PPO
  • Aetna PCP Coordinated POS Plan
  • Aetna Quality Point of Service (QPOS)
  • Aetna Select HMO
  • Aetna Traditional Choice
  • Aetna Voluntary Indemnity Group Plan
  • Aetna Whole Health – Duke WakeMed WKCC
  • Aetna/CVS Health

Ambetter

  • Ambetter of North Carolina

Blue Cross Blue Shield of North Carolina

  • Blue Advantage
  • Blue Medicare (HMO, PPO)*
  • Blue Options (123, PPO, HSA)
  • Blue Select
  • NC State Employees Health Plan

*Duke HomeCare and Hospice does not participate in this plan.

Bright HealthCare

CIGNA

  • Cigna Behavioral Health (*Limited eligibility)
  • Cigna Choice Plus
  • Cigna Connect Individual Family Plan
  • Cigna Open Access
  • Cigna Open Access Plus

*Please call Cigna Behavioral Heath to see if the provider is participating in your plan.

Duke Group Plans

  • Duke Basic
  • Duke Select

Experience Health

  • Experience Health Medicare Advantage (HMO) Plan

First Health

Gateway Health Alliance

Halifax Physician-Hospital Organization*
*This plan is only accepted at Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, and Duke HomeCare & Hospice.

Healthgram

Humana

  • Humana Choice (PPO)
  • Humana Choice - Medicare Advantage (PPO)
  • Humana ChoiceCare - Medicare Advantage (PPO)
  • Humana Gold Choice - Medicare Advantage (PFFS)
  • Humana Gold Plus - Medicare Advantage (HMO)
  • Humana Medicare Advantage Group Plan - NC State Retirees

MedCost

Medicare

  • First Medicare Direct
  • Medicare Part A
  • Medicare Part B

MultiPlan / Private Healthcare Systems

NC Medicaid

  • AmeriHealth Caritas North Carolina
  • Carolina Complete Health
  • Healthy Blue
  • NC Medicaid Direct
  • UnitedHealthcare Community Plan*
  • WellCare of North Carolina

*As of October 15, 2022, Duke Health will no longer participate in UnitedHealthcare Community Plan. Patients who want to continue to see their Duke providers at Duke locations after October 15, 2022, are encouraged to pick one of the other managed Medicaid plans in which Duke Health participates. Learn more.

Optima Health

  • FAMIS*
  • Optima Family Care (Medicaid HMO in VA)*
  • Optima Individual & Family (On & Off Exchange Plans)
  • Optima Plus (PPO)
  • Optima Vantage (HMO)

*Duke Primary Care, Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital are not participating in these plans.

Progyny*

*This plan is only accepted at the Duke Fertility Center.

TRICARE

  • TRICARE Prime
  • TRICARE Prime Remote
  • TRICARE Select

United Healthcare

  • AARP Medicare Advantage Plan 2 (HMO-POS)
  • AARP Medicare Complete (HMO, PPO)*
  • AARP Medicare Complete Essential (HMO)*
  • All Savers Alternate Funding
  • All Savers Fully Insured
  • United Healthcare (HMO, PPO, POS)
  • United Healthcare Charter/Charter Balance/Charter Plus
  • United Healthcare Choice/Choice Plus
  • United Healthcare Core/Core Essential
  • United Healthcare Navigate/Navigate Plus/Navigate Balanced
  • United Healthcare Option PPO
  • United Healthcare Passport Connect Choice/Choice Plus
  • United Healthcare Passport Connect Options PPO
  • United Healthcare Select/Select Plus
  • United Healthcare Shared Services - Harvard Pilgrim/UHC Options PPO Network
  • United Medical Resources (UMR)

*Duke HomeCare and Hospice and mental health providers do not participate with the plan.