Payment and Insurance
If you need assistance with healthcare and payment options, and whether or not you have insurance — we are here to help you!
What insurance do you accept?
If you have insurance, we accept a number of plans at Esperanza:
- Medicaid: Department of Human Services, Designer, Health Partners, Keystone First, United Health Care Plan for Families, UPMC Community Plan and UPMC For You.
- Medicaid Community Health Choices (CHCs): Keystone First CHC, PAHW CHC secondary, UPMC CHC secondary
- CHIP: Aetna Better Health CHIP Kids; Keystone East CHIP; Kidz Partners; UHC CHIP Community Plan for Kids: UPMC for kids
- Medicare/ Medicare Advantage: Original Medicare; Aetna Medicare Plans; Aetna Advantra; Cigna HealthSpring Medicare HMO; Health Partners Medicare Plans; Keystone 65; Keystone VIP Choice; United Healthcare Medicare; UPMC Life complete care and UPMC for Health Medicare
- Commercial Health Insurance Plans: Aetna, Cigna, Geisinger, Independence Administrators, Keystone Health Plan East, Keystone ACA plans; Personal Choice; UHC Commercial; United Healthcare PPO
Please note that if you are part of an HMO, you will need to contact the insurance company to request a change to one of our clinicians before we can begin to take care of you. It is also your responsibility to notify us about any changes in your insurance coverage.
What if I don’t have health insurance – can I still become a new patient at Esperanza?
We can help you apply for insurance! Please call us at (215) 302-2210 to make an appointment with one of our bilingual Insurance Assisters, or ask one of our staff members about insurance assistance during your visit. Our Insurance Assisters will gladly help you to determine your eligibility for insurance plans and programs, including:
- HealthChoices (Medicaid): You can apply for insurance under Pennsylvania’s HealthChoices (Medicaid) program if you are a Pennsylvania resident ages 21 to 64 who meets the income criteria.
- Marketplace Insurance Options (“ObamaCare”): You are eligible to apply for Marketplace Insurance plans under the Affordable Care Act (“ObamaCare”) if you are age 18 or older and are a U.S. citizen/national or are lawfully present in Pennsylvania.
If you are not eligible for insurance coverage, you may still become an Esperanza patient and apply for discounted care through our Uninsured Patient Program. Under this program, your fee may be anywhere from $20 to $60 for a medical or dental visit. This sliding scale fee is based on your income and family size. You will need to meet with the Patient Access Liaison (PAL) prior to your first appointment to review your household size and proof of income to determine eligibility. Proof of your household income may include:
- Most recent tax return or W2
- Most recent paycheck stubs for each working family member (one month’s income)
- Letter from your employer stating your income if working under the table
- SSA, SSI, or Unemployment award letters
Patients of Esperanza Health Center will not be denied access to services due to inability to pay. If you believe that you are unable to pay the nominal fee that is requested by our sliding fee scale, please ask to speak with the office manager prior to your visit.
Also, uninsured persons who are HIV-positive will receive care at Esperanza on a sliding-fee scale through funding from a Ryan White Grant.