Insurance We Accept
WakeMed contracts with a wide variety of managed care plans and insurance companies, while also participating in the government programs of Medicare and Medicaid. Following find a list of plans offered in our market currently accepted at WakeMed's facilities & physician practices.
By law, all insurance products must cover emergencies. If you are having an emergency, please select your care location based on proximity rather than insurance coverage.
Additionally, if your insurance product is not sold in our market, then it will not be on the list below, but that does not mean we do not accept your plan. To determine if your plan is accepted by us, please call Customer Service at 919-350-8359 to verify acceptance.
Insurance We Accept
To learn more about our the insurance products we accept, click to expand the appropriate section.
Have questions? Don't see your insurance listed? Call us 919-350-8359.
If you have questions related to your insurance plan, we encourage you to call Customer Service 919-350-8359. The hours of operation are Monday - Friday, 7:30 am - 5:30 pm. The CareLine is a central resource for any insurance verification and preauthorization issues.
Updated April 2024
Don't see your insurance listed? Have questions? Call us 919-350-8359.
Commercial Insurance
- Aetna (including Aetna Connected)
- Ambetter
- American Health Alliance
- Assurant Health
- Atlantic Integrated Health/Beacon Company
- Beech Street
- Blue Cross Blue Shield - (excluding Blue Home, Blue Local, Blue Value, and Blue High Performance Network (HPN)
- Cigna Health Care (including Cigna Connect, excluding Cigna Surefit)
- Coventry National
- Coventry Preferred PPO
- Duke Select / Duke Basic (For limited services. Contact Aetna Member Services to confirm participation.)
- Evolutions Healthcare Systems *Out of Network for WakeMed Physician Practices
- First Health PPO
- Great-West Healthcare
- Humana ChoiceCare Network
- MEDCOST
- Multiplan, Inc.
- NC State Employee Health Plan (benefit levels may be lower for patients enrolled in the Clear Pricing Project)
- NPPN/Plan Vista *Out of Network for WakeMed Physician Practices
- OneNet PPO
- Paradigm Health Corporation *Out of Network for WakeMed Physician Practices
- Primary Physicians Care
- Private Healthcare Systems (PHCS)
- UnitedHealthcare (excluding Charter Benefit Plans, Doctors Plan Benefit Plans and Healthcare Marketplace/Exchange plans)
Medicare
WakeMed is pleased to participate in the following Medicare & Medicare Advantage Plans.
Medicare Advantage
- AARP Medicare Advantage by UnitedHealthcare HMO, POS, PPO
- Aetna Medicare HMO, POS, PPO
- Alignment Health HMO, POS, PPO
- Blue Medicare HMO, POS, PPO (in-state and out-of-state)
- Cigna Medicare HMO, PPO*
- Experience Health HMO
- FirstMedicare Direct SmartHMO (Wake County residents only)
- Healthy Blue + Medicare Dual Eligible Special Needs Plan
- Liberty Medicare Advantage HMO
- PruittHealth Premier HMO
- United Healthcare Medicare HMO, POS, PPO – including AARP Medicare Complete and United HealthCare Dual Complete (excluding Medicare Select and Medicare Advantage private fee-for-service and medical savings account benefit plans)
- Wellcare Medicare HMO, PPO (North Carolina residents only)
*As of midnight on December 31, 2024, WakeMed will be out-of-network with Cigna’s Medicare Advantage plans: Cigna Courage Medicare (HMO), Cigna Preferred Medicare (HMO), Cigna Preferred Plus Medicare (HMO), Cigna Preferred Savings Medicare (HMO), Cigna Preferred Select Medicare (HMO), Cigna TotalCare (HMO D-SNP), Cigna TotalCare Plus (HMO D-SNP) and Cigna True Choice Medicare (PPO).
WakeMed is a participant in NC Medicaid & NC Health Choice.
On July 1, 2021, NC Medicaid transitioned to Medicaid Managed Care Health Plans.
As part of this transformation, the majority of Medicaid members are now in a Medicaid Managed Care plan.
WakeMed currently has a contract with the following Medicaid managed care plans in our region:
- Amerihealth Caritas
- Healthy Blue
- Carolina Complete Health
- UnitedHealthcare Community Plan
- WellCare Health Plans, Inc.
Medicaid Tailored Plans
North Carolina launched the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan on July 1, 2024. Tailored Plans cover specific Medicaid enrollees who are currently members of NC Medicaid Direct.
- Alliance Health Tailored Plan (includes only WakeMed Raleigh facility, WakeBrook facility and limited WakeMed Physician Practice locations)
What This Means for You
- Emergency services are covered regardless of your plan at any emergency department.
- You will be required to seek non-emergency care from specific doctors, hospitals and health care organizations that are in-network with your Medicaid managed care plan.
- WakeMed must get prior authorization to be paid for almost all services. If WakeMed is out of network, it is unlikely that we will receive authorization. This means you may not be able to receive non-emergency care from WakeMed hospitals and providers.
- While our hospitals and emergency departments are in-network with the plans listed above, not all of our physician practices accept Medicaid. Please contact your health care provider’s office before scheduling an appointment to confirm your Medicaid plan is accepted.
Have Insurance Changes for 2025?
Update your insurance information in the Insurance Summary section of MyChart.
Step-by-Step guide on how to make this update on a computer:
English version | Spanish version
Step-by-Step information on how to make these changes within the MyChart app.
Please Note: WakeMed Children's PM Pediatrics Urgent Care accepts these insurances.
In addition to the bills you will receive for inpatient and outpatient services provided by WakeMed, you may receive bills from other physicians who are either independent practitioners in private practice and not employed by WakeMed or providers we contract with for certain services.
While these physicians provide services for WakeMed, they do not necessarily accept the same insurance plans as the hospital. Please check with your insurance plan to verify these providers are in your network, otherwise you may be faced with higher costs.
The following physician groups have contracted with WakeMed to provide additional professional services to patients.
These providers will bill separately for their professional fees.
- Surgeries performed after October 1, 2023:
- East Carolina Anesthesia Associates (ECAA) - (800) 410-0453
- Surgeries performed prior to October 1, 2023:
- American Anesthesiology, division of NAPA (Anesthesia Services) – (866) 306-6007
- Raleigh Radiology (Imaging Interpretation Services) – (919) 342-0340
- Raleigh Pathology Laboratory Associates (Pathologist Services)
- Service before 11/1/21 – (919) 350-7888
- Service 11/1/21 and after call APS at (800) 284-9806