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Navigating Medicare Advantage

What you need to know about out-of-network coverage

Not all Medicare Advantage plans are in-network with VCU Health. If your plan is out-of-network, you may pay more when you see one of our providers or come to one of our locations.  

VCU Health accepts all Medicare Supplemental Plans, so if you have one, you won’t need to worry about extra out-of-network costs.

VCU Health still participates in many Medicare Advantage networks, including:

  • Aetna 
  • Anthem
  • Humana

See our list of participating plans for more information about what Medicare Advantage plans are in-network.

If you have questions about an upcoming appointment, call the VCU Health Patient Appointment Center at 800-762-6161.

What you can expect to pay

If you have an out-of-network plan, you can still come to us for care. However, you’ll need to pay for any non-emergency visits ahead of time. You’ll pay half the estimated cost when you make your appointment and the other half before your appointment.

Your appointment could be cancelled if you don’t pay the full amount. If you paid ahead of time but have an in-network plan on the day of your appointment, you’ll get a refund.

If you come to us for emergency care, we’ll sent the bill right to your insurance provider. You’ll likely pay the same amount you would pay with an in-network plan, according to Medicare’s No Surprises initiative.

Get to more information about your plan  

Out-of-network plans affect all our locations, services and providers. If you are a Transplant or Behavioral Health patient, you may need to call your insurance provider to see if your care is covered.

If you have general billing questions, call VCU Health Customer Service at 888-803-0082.

If your plan is out-of-network and you want to know your options, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

You can also call the Virginia Insurance Counseling and Assistance Program (VICAP) and talk to a trained volunteer at 1-800-552-3402.

You can switch to another Medicare Advantage plan during open enrollment between October 15 and December 7, 2025. If you change your plan during this period, your new plan will start on January 1, 2026.

You may be able to sign up for a new plan during a special enrollment period. These special enrollment periods are evaluated on a case-by-case basis, such as if you have a major life change or if your plan changes its Medicare contract.