NYMD Center accepts most major insurance plans at both our Manhattan and Forest Hills offices, and we work with every patient to make the cost of care clear before it is delivered. This page explains how coverage works with us, what to do if you are paying without insurance, and where to find the other options we offer.
Verifying your coverage
The most important thing to know is that insurance participation varies by physician and by location. A plan that one of our physicians participates in may not include another, and networks change from year to year. For that reason we do not publish a list of accepted plans, which would be out of date the moment a network changed. Instead, we verify coverage individually.
When you book, give the front desk your plan name, the member ID on your card and the name of the physician or specialty you want to see. We check your eligibility and benefits before the visit and tell you what to expect: whether the physician participates, what your copay is likely to be, and whether your plan requires a referral. If you would like the cost of a specific test or procedure before it is done, ask and we will look it up.
Bring your insurance card and a photo ID to every visit. If your coverage changes, tell us before the appointment rather than at check-in, so the visit can be verified against the new plan.
Referrals and authorizations
Some plans require a referral from your primary care physician before a specialist visit is covered, and some procedures and imaging studies require prior authorization from the insurer. Our staff handle authorizations for procedures we schedule; referrals for the initial visit must come from your primary care physician if your plan requires them. If our internal medicine physician is your primary care doctor, that referral is handled inside the group.
Self-pay
You do not need insurance to be seen. We offer self-pay pricing for office visits, on-site lab testing, ultrasound, EKG and many procedures, and we will tell you the cost before anything is done. Because most of our procedures are performed in our office-based surgery center rather than a hospital, there is no separate facility fee, which often makes the total cost of a procedure lower than a patient expects.
Good-faith estimates
Under the federal No Surprises Act, patients who are uninsured or who choose not to use insurance have the right to a written good-faith estimate of expected charges before a scheduled service. We provide these on request and automatically for scheduled procedures. Our No Surprises Act page explains your rights and how to request an estimate.
Concierge care
For patients who want direct access to their physician, longer visits and priority scheduling, we offer a concierge tier. It is a membership that runs alongside insurance rather than replacing it. The concierge page describes what is included.
Questions about a bill
If something on a statement does not make sense, call the office where you were seen. Our billing staff can explain how a claim was processed, what your plan paid and what remains your responsibility, and can help if a claim was denied for a correctable reason such as a missing referral. Most billing questions are resolved with a single phone call.
For anything not covered here, contact us or ask the front desk at your next visit.
Questions patients ask
Do you accept my insurance?
We accept most major insurance plans, but participation varies by physician and by office, and plans change their networks from year to year. The reliable answer comes from a phone call: give the front desk your plan name and member ID, and we will verify whether the physician you want to see participates and what your visit is likely to cost.
What if you do not take my plan, or I have no insurance?
You can still be seen. We offer self-pay pricing for visits, testing and many procedures, and we provide a written good-faith estimate in advance as required by the No Surprises Act. Because so much is done in the office rather than a hospital, there is no separate facility fee, which keeps the total cost of many procedures lower than patients expect.
Will I owe a copay or deductible at the visit?
Usually, yes. Copays are usually due at the visit, and if your plan has a deductible that has not been met, some or all of the visit cost may be your responsibility. We verify your benefits when you book and will tell you what to expect. If you want to know the cost of a specific test or procedure before it is done, ask, and we will look it up.
What does the concierge tier include?
The concierge tier is a membership for patients who want direct physician access, extended visits and priority scheduling. It is separate from insurance and does not replace it. Details, including what is and is not included, are on the concierge service page. It suits patients who value time and access over the standard appointment structure.
Make an appointment
Manhattan (212) 991-9991 · Forest Hills (718) 360-9550 · same-week visits, most major insurance accepted.