bio Medical Director of Pedre Integrative Health

Insurance and Fees

Plans Accepted: The following is a list of plans accepted for General Primary and Preventative Care at this time. Please check back with our office as this list may not be current Acupuncture services are only covered under United Healthcare and Cigna. Dr. Pedre is currently accepting new patients on all plans, except Medicare, but please check with our office as this may also change in the future.

  • Aetna HMO
  • Aetna
  • Beech Street
  • Cigna HMO
  • Cigna*
  • First Health
  • HIP
  • Medicare
  • Oxford (Freedom, Medicare)
  • PHCS
  • United Healthcare*
  • UHC-top tier* (Mount Sinai Hospital employees only)

 
Cignacase basis. If you have Cigna or United Healthcare your plan benefits may not include acupuncture. Please check with your plan. These benefits may be diagnosis specific, require prior authorization, and may be limited to a certain number of visits. If you have scheduled an acupuncture appointment, you should call your plan to obtain this information prior to your first visit. Our front desk can also help you with this.

Acupuncture Fees

Please call our office for our current acupuncture fees. If acupuncture is not covered by your insurance, we will design a program for you. We offer a sliding scale on a case by case basis.

Out of Network

If you have Blue Cross/Blue Shield or any other insurance not listed above, our services are out-of-network for you.

This does not mean that you cannot receive care from our office. What this means is that you will have to pay out-of-pocket for any services provided. We will provide you with the proper forms to file with your insurance company so that you may seek reimbursement for your medical expenses. Usually expenses are reimbursed at 80% of qualified medical expenses beyond your deductible.

What is an out-of-network deductible?

This is the amount you need to pay out-of-pocket for any services not covered by your insurance plan. The deductible does not carry over past January 1st ; in other words, your deductible resets at the beginning of the calendar year whether or not it has been met. Your deductible is the amount you have to first pay out-of-pocket, after which your insurance will cover and reimburse you for a prearranged percent of eligible medical expenses. For example, your deductible may be $200, $500, $1000 or $2000. The amount they may reimburse you for after your deductible has been met is usually in the range of 75% - 80% of qualified medical expenses (again incurred after you have met your deductible). This means you are responsible for the other 20-25%, unless you have secondary insurance. There may also be different deductibles for outpatient versus inpatient (or hospital) services as well as yearly in-network deductibles that vary from plan to plan. There is no way to know this without calling your insurance plan and inquiring. Complicated? Not really, but it takes a little bit of thinking to understand.

If you need any help understanding these concepts, or would like to make an appointment, please do not hesitate to contact our office at (212) 860-8300.

Uninsured Patients/ Financial Arrangements

Truth No. 1: Your health is an investment.

Truth No. 2: Invest in your health.

Truth No. 3: Postponing your health may make it even more expensive.

Being without insurance is no fun. At Pedre Integrative Health, we understand the stresses and heartache this may cause. We also understand that most uninsured patients are usually not full-time employees. They are artists, consultants or temporarily unemployed and have monetary constraints or they may be individuals with low-paying jobs that do not offer insurance. We believe that although financial constraints are of utmost importance, neglecting one's health because of lack of medical coverage may be the costlier decision.

Your health is your investment as well as ours. Lack of health insurance coverage should not equate with lack of access to good, quality care. At Pedre Integrative Health, we strive to provide every single one of our patients, regardless of insurance or financial status, high-quality care with minimal waiting time. We try to be sensitive to cost issues as well and can work out a payment arrangement on a case by case basis.

Please call us at (212) 860-8300 to find out our rates and learn how we can help out.