Duke University Hospital: Tricare Insurance Acceptance

Duke Health contracts with most major health insurance carriers and transplant networks. However, it is important to note that Duke Health does not participate in all insurance plans and certain services may not be covered. For example, Duke Health does not participate in UHC plans on the Health Insurance Marketplace and does not cover mental health, home health, or home infusion services for United Healthcare Medicare Advantage plans. To determine if Tricare insurance is accepted by Duke University Hospital, it is recommended to contact the insurance company directly or refer to their website for a list of accepted insurance plans. Duke University also offers a Student Medical Insurance Plan (SMIP) for students who have no insurance or inadequate coverage, which is tailored to meet the specific needs of students enrolled at Duke University.

Duke Health's accepted insurance plans

Duke Health contracts with most major health insurance carriers and transplant networks. The list of health insurance plans accepted by Duke Health is not all-inclusive and is updated periodically, so it is recommended that patients call their insurance company to ask about their access to healthcare services at Duke Health locations and what co-payments, co-insurances, and deductibles will be their responsibility. The Duke Consultation and Referral Center can also review the list of accepted insurance plans with patients.

Some of the insurance plans accepted by Duke Health include CIGNA Healthcare of NC (HMO, POS, and PPO plans), although it should be noted that only some services and benefits are covered, which may result in higher out-of-pocket expenses for services not covered by Cigna at Duke Health. Duke Health also accepts Progyny, but only at the Duke Fertility Center. United Healthcare (HMO and PPO plans) is accepted, although Duke Health does not participate in UHC plans on the Health Insurance Marketplace. These plans are available through Healthcare.gov.

Duke Health Lake Norman Hospital accepts the insurance plans previously mentioned, as well as BARiNet Preferred Provider, LLC -- commercial Insurance, Bariatric Surgery, Carolina Complete Health Network, Inc. - Managed Medicaid, Devoted Health, Inc. – Medicare Advantage, Healthgram, Inc. – Commercial Insurance, and Vaya Health, Inc. - Tailored Plan. Kernodle Clinics accepts these plans in addition to the plans accepted by Duke Health. Aetna Focus Plan is accepted but only for Cone Health employees.

Duke Health also participates with Medicare and many of the Medicare Advantage plans offered in the North Carolina market, but not all of them. Duke Health does not participate in United Healthcare Medicare Advantage (HMO, PPO, and SNP plans) for mental health, home health, or home infusion services. This may increase out-of-pocket expenses.

In the Triangle area, Duke is considered "in-network" for Blue Cross Blue Shield Blue Local with Duke Medicine and WakeMed, Coventry One, and United Healthcare Compass. These products are available by county, so patients must check in their specific county to see what their options are.

Duke Health's insurance for international students

Duke University requires all international students holding an F1 or J1 visa to enrol in the Student Medical Insurance Plan (SMIP) or Student Blue. This is mandatory and is designed to meet the needs of students who have no insurance or inadequate insurance coverage in the Durham, NC area. The plan is underwritten by Blue Cross and Blue Shield of North Carolina (BCBSNC) and provides quality health insurance to meet any additional medical needs not covered by the Duke Student Health Fee.

The Student Blue plan offers partial reimbursement for the purchase of frames, glasses, or contact lenses. It is important to note that Student Blue does not cover dental services, and dental insurance must be purchased separately through Blue Cross/Blue Shield. The Duke International Student Center (DISC) strongly recommends that all F-2 dependents also purchase health insurance.

International students at Duke University are encouraged to familiarise themselves with the American health insurance system to ease their transition to campus. Duke offers supplemental health insurance at no additional cost for full-time, benefits-eligible employees travelling internationally for up to six months on Duke business. This coverage, called Cigna Medical Benefits Abroad (MBA), provides supplemental medical insurance for unexpected injuries and illnesses while travelling abroad on Duke business.

Duke Health contracts with most major health insurance carriers and transplant networks. However, it is always a good idea to contact your insurance company directly to confirm that you have access to healthcare services at Duke Health locations and to understand any co-payments, co-insurances, or deductibles that may be your responsibility.

Duke Health's insurance for students with inadequate coverage

Duke University Hospital accepts insurance plans from major health insurance carriers and transplant networks. These include United Healthcare (excluding mental health, home health, and home infusion services), Cigna Healthcare of NC, and Blue Cross Blue Shield of North Carolina (BCBSNC). Duke Health also participates with Medicare and some Medicare Advantage plans offered in the North Carolina market.

Duke University requires all students to maintain adequate medical insurance during their enrollment. For students with inadequate insurance coverage, Duke offers the Student Medical Insurance Plan (SMIP), also known as Student Blue. This plan is specifically designed to meet the needs of students with inadequate coverage in the Durham, NC area. SMIP provides unlimited emergency and non-emergency routine healthcare, mental health benefits, and prescription medication coverage. It is underwritten by Blue Cross Blue Shield of North Carolina (BCBSNC), offering access to one of the largest provider networks in the United States.

International students holding an F1 or J1 visa are mandated to enroll in the SMIP. Additionally, international students are required to pay the Student Health Fee, which allows them to receive medical care at the Duke Student Wellness Center. This fee covers access to various services, including a pharmacy, dental office, counseling center, and nutrition services.

Students with adequate coverage under another health insurance plan may waive the SMIP by providing proof of their existing coverage. However, it is recommended that students review their current coverage as the SMIP is tailored to meet the specific needs of Duke students.

Duke also provides supplemental health insurance, Cigna Medical Benefits Abroad (MBA), for full-time, benefits-eligible employees traveling internationally for Duke business. This coverage supplements the regular Duke health insurance plan or the employee's existing coverage and includes their spouses, registered same-sex partners, and dependents up to age 26.

Duke Health's insurance for employees

Duke Health contracts with most major health insurance carriers and transplant networks. Duke Health is also contracted to participate with insurance products and provider networks that offer both primary and specialty care. Duke Health does not participate in UHC plans on the Health Insurance Marketplace. However, it does participate with Medicare and many of the Medicare Advantage plans offered in the North Carolina market, but not all of them.

Duke Health offers its employees a range of health insurance plans, including supplemental health insurance at no additional cost for full-time employees travelling internationally for up to six months. Duke also offers five different medical plans, including Duke Select, Duke Basic, Blue Care, Duke Options, and Duke USA, which cover both pharmacy and behavioural health benefits.

Duke also offers a choice of dental care plans, as well as a nationwide vision care plan to manage the cost of eyeglasses and contact lenses. Duke employees who smoke or use tobacco products are charged an extra $50 per month, but this surcharge can be removed upon completion of a tobacco cessation program.

Duke Health also provides expanded employee health coverage for virtual visits, including COVID-19 lab tests, which are covered under the standard copay, coinsurance, or deductible charges.

Duke Health's pharmacy insurance

Duke Health contracts with most major health insurance carriers and transplant networks. Duke Health does not participate in UHC plans on the Health Insurance Marketplace. However, it does participate with Medicare and many of the Medicare Advantage plans offered in the North Carolina market, but not all of them.

Duke Health recommends that patients call their insurance company and ask if they have access to health care services at Duke Health locations and what co-payments, co-insurances, and deductibles will be their responsibility. The Duke Consultation and Referral Center can also review the list of Duke Health-accepted insurance plans.

Duke University also offers a Student Medical Insurance Plan (SMIP) for students with no insurance or inadequate insurance coverage in the Durham, NC area. The plan is underwritten by Blue Cross Blue Shield (BCBS) of North Carolina and has received a platinum tier rating under the Affordable Care Act rating system. Students under a parent or guardian's PPO dental insurance plan can use their plan at the dental office. Duke accepts all major PPO insurance plans, including but not limited to Aetna Dental, Blue Cross Blue Shield (Dental Blue), Cigna, Delta Dental, Guardian, Humana, Met Life, United Concordia, United Healthcare, and more.

Frequently asked questions