YOUR VISIT
Insurance
We accept most major insurance providers
Please make sure you bring your insurance card to your appointment. In the event that it is not yet issued to you, please bring the policy details.
AdventHealth Clinically Integrated Network (CIN)
AdventHealth Employee Plan (Administered by Aetna), AMPS, Centivo, Disney CastCare (Administered by Allegiance)Advantage Health Network
Tenet Employee Plan (Administered by Cigna)Aetna
HMO & EPO Plans: Aetna Health Network, Aetna Select EPO, Open Access Aetna EPO, Aetna Open Access Elect Choice EPO; POS & PPO Plans: Quality Point of Service (QPOS), Managed Choice POS, Aetna Open Access Managed Choice POS, Aetna Choice POS II, Aetna Health Network Options, Open Choice POS; Coventry Products: HMO, POS/Open Access, PPO, Individual, National, Network Access, CoventryOne, First Health Network++AvMed
All products except Non-Par for FlexBaptist Health Quality Network
Employee Plan Only (Administered by Aetna & UHC)
Baptist Physician Partners
Employee Plan Only (Administered by Aetna & Florida Blue)Baycare Exclusive Network
Employee Plan ONLY (Administered by Cigna)BCBS Florida
PPO includes BlueOptions (Traditional PPS/PHS & Network Blue), BlueChoice (Traditional PPS/PHS & PPC), BlueSelect (Traditional PPS/PHS & BlueSelect), FEP Basic (PPC), FEP Standard (Traditional PPS/PHS & PPC), FEP Focus (PPC), State Employees’ PPO (Traditional PPS/PHS & PPC), Canadian Travel Insurance (PPC); Health Options includes BlueCare myBlue, SimplyBlue; BeHealthy Florida/Truli for HealthCigna
HMO (HMO POS, Network, Network POS, POS), Sure Fit, LocalPlus, PPO/EPO, Cigna+Oscar Cigna CACClaritev [Multiplan]
Beech Street, PHCS, ++
Community Care Plan (CCP)
Employees Only Healthcare Program Effective 1/1/2025
Curative
Effective 1/22/2025Dimension Health
Evolutions, Global Excel, AXA HAA PP, Medipac, USA Managed Care, Sanus Health, PPO NetworkEmployers Health Network
Florida Accountable Care Services (ACO)
Cigna & UHC, Contract Termed
Florida Health Care Plan
Humana
HMO, POS, PPO, EPO, Humana Medical Plan & Traditional PlansImagine Health
Jupiter Medical Center Collaborative Care Network
Larkin Community Hospital Palm Springs Network
Primary Care OnlyMemorial Health Network
MHS Employee Plan – MMCP, MCHP, CCP/CCP+, Memorial Health Assurance through Employers Health Network, Oscar, UHC, BCBSOrlando Health Network
Orlando Health Team member Health Plan (UMR), Orlando Health Disney Cast Advantage Plan (Allegiance), Aetna ACO & Cigna COVID Care Model ACOParrish Health Network
PHN Employee Plan (Administered by Health Plans Inc.)
Partners Direct Health
Point Comfort Underwriters
Office of Refugee Resettlement Unaccompanied Children ProgramTricare East (Humana Military)
Tricare Prime, Tricare Prime Remote, Tricare Prime Overseas, Tricare Prime Remote Overseas, Tricare Select, Tricare Select Overseas, Tricare For Life, Tricare Reserve Select, Tricare Retired Reserve, Tricare Young Adult, US Family Health PlanUnited HealthCare HMO, PPO, Options PPO, Choice, Choice UMR, Neighborhood Health, Golden Rule, UHC One, Nexus, Surest Health Plans/Bind, and Mount Sinai Health Network, UHC Heritage Plus
AdventHealth CIN
Health First Health Plan, OscarAetnaCVSHealth IFP
QHP: Gold & Silver, IVL - Term Date 12/31/2025Ambetter
Essential Care, Secure Care, Balanced Care; Bronze, Silver or Gold EPO: Clear, CMS Standard, Choice, Complete, Elite, Enhanced, Everyday, Focused, Bronze, Silver or Gold HMO: Select, ValueAmerihealth Caritas
NextAvMed
Entrust
BCBS Florida
Health Options HMO, Blue Options PPO, Simply Blue HMO
Cigna
Cigna ConnectMolina Marketplace
Oscar Health
Simply Florida Essential
Effective date 01/01/2025
Aetna Better Health
Community Care Plan (CCP)
Simply Healthcare Plan
Aetna Better Health
AmeriHealth Caritas
No longer offered effective 2/1/2025Community Care Plan (CCP)
Florida Community Care (FCC)
Effective 2/1/2025Humana Healthy Horizons
Molina Healthcare
Simply Healthcare Plan
Sunshine Health
Sunshine CMS Title XIX & XXI
United HealthCare Community Plan
Insurance FAQs
We accept most insurance and Medicaid plans.
Most services are covered, but we do recommend you contact your insurance company to verify your plan benefits. Below are a few suggested questions to ask:
Does your health plan require an assigned PCP (for example, an HMO)? If yes, verify that a Pediatric Associates provider is your assigned PCP. Generally, this will populate on your Member ID Card.
Are there any limits on preventative care I need to know about? How is that different than my coverage for a sick visit?
Do I have a co-pay or deductible?
Is there additional patient responsibility if the services are provided after hours?
Call our Billing Department at 954-967-6400 ext 7422 and we will be glad to assist you with that process.
Sliding fee discount program
At Pediatric Associates, no patient will be denied medical services due to inability to pay. We offer a sliding fee discount program to those who qualify.
Determining your eligibility for the sliding fee discount requires verification of your income. This information must be updated frequently to continue your participation in the program. The information is only used to calculate your discount and is kept completely confidential.
If you wish to apply, please click on the button below to fill out an application prior to scheduling an appointment or returning to your location. You may also submit the application directly to SFSAPPS@pediatricassociates.com.
Sliding fee discount schedule
| Poverty level | 100% | 110% | 120% | 130% | 140% | 150% | 160% | 170% | 180% | 190% | 200% | >200% |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Family size | Discount 100% | Discount 90% | Discount 80% | Discount 70% | Discount 60% | Discount 50% | Discount 40% | Discount 30% | Discount 20% | Discount 15% | Discount 10% | Discount 0% |
| 1 | $15,650 | $17,215 | $18,780 | $20,345 | $21,910 | $23,475 | $25,040 | $26,605 | $28,170 | $29,735 | $31,300 | >$31,300 |
| 2 | $21,150 | $23,265 | $25,380 | $27,495 | $29,610 | $31,725 | $33,840 | $35,955 | $38,070 | $40,185 | $42,300 | >$42,300 |
| 3 | $26,650 | $29,315 | $31,980 | $34,645 | $37,310 | $39,975 | $42,640 | $45,305 | $47,970 | $50,635 | $53,300 | >$53,300 |
| 4 | $32,150 | $35,365 | $38,580 | $41,795 | $45,010 | $48,225 | $51,440 | $54,655 | $57,870 | $61,085 | $64,300 | >$64,300 |
| 5 | $37,650 | $41,415 | $45,180 | $48,945 | $52,710 | $56,475 | $60,240 | $64,005 | $67,770 | $71,535 | $75,300 | >$75,300 |
| 6 | $43,150 | $47,465 | $51,780 | $56,095 | $60,410 | $64,725 | $69,040 | $73,355 | $77,670 | $81,985 | $86,300 | >$86,300 |
| 7 | $48,650 | $53,515 | $58,380 | $63,245 | $68,110 | $72,975 | $77,840 | $82,705 | $87,570 | $92,435 | $97,300 | >$97,300 |
| 8 | $54,150 | $59,565 | $64,980 | $70,395 | $75,810 | $81,225 | $86,640 | $92,055 | $97,470 | $102,885 | $108,300 | >$108,300 |
| For each additional person | $5,500 | $6,050 | $6,600 | $7,150 | $7,700 | $8,250 | $8,800 | $9,350 | $9,900 | $10,450 | $11,000 | >$11,000 |
*Based on the 2025 Federal Poverty Guidelines for the 48 contiguous states and the District of Columbia. Please note that there are separate guidelines for Alaska and Hawaii, and that the thresholds would differ for sites in those two states. Sites in Puerto Rico and other outlying jurisdictions would use the above guidelines
Pediatric Associate Group has adopted the following policies on charges for health care services: We will charge persons receiving health services at the usual and customary rate prevailing in the area. Persons will be charged for services to the extent that payment will be made by a third party authorized or under legal obligation to pay the charges. Health services will be provided at no charge, or at a discounted charge, to persons unable to pay for care. We will not discriminate against any person receiving health services because of his or her inability to pay for services, or because payment for health services will be made under Part A or B of Title XVIII (Medicare) or Title XIX (Medicaid) or Title XXI (Health Wave, the state children’s health insurance) of the Social Security Act.