James Eskew MD, FACS

Insurance & You

Thank you for choosing James Eskew, MD, FACS for your ENT care. We’re here to help make your experience as smooth as possible.

Understanding insurance can be confusing, so we’ve put together this quick guide to help.

Insurance Plans We Accept

Our list of accepted insurance plans can change, but currently we accept:

  • Blue Cross Blue Shield (HMO plans require a referral)
  • Aetna
  • Cigna
  • Traditional Medicare
  • Oscar (some plans require a referral)
  • Tricare (some plans require a referral)
  • PHCS

If you have Humana or United Healthcare, we’re happy to see you, but your out-of-network benefits will apply. We are working to join additional networks, including Humana, United Healthcare, Molina, Sendero, and Ambetter.

Medicare: What You Should Know
  • Traditional Medicare: Usually a red, white, and blue card
  • You may also have a secondary insurance (like AARP, Blue Cross, or Mutual of Omaha)
  • Medicare Advantage Plans:
    These replace traditional Medicare and are offered by companies like:
    • Aetna
    • Blue Cross Blue Shield
    • Cigna
    • Humana
    • United Healthcare

If you’re unsure what type of plan you have, just ask — we’re happy to help.

HMO vs. PPO
  • HMO plans require a referral and authorization from your primary care doctor before seeing a specialist
  • PPO plans usually do not require referrals
Common Insurance Terms
Copay

A fixed amount you pay at your visit. This varies depending on the type of care (primary, specialist, urgent care).

Deductible

The amount you pay out of pocket before your insurance starts paying.

Coinsurance

Your share of the cost after your deductible is met (usually 10–40%).

Out-of-Pocket Maximum

The most you’ll pay during your plan period. This includes copays, deductibles, and coinsurance.

If You Need Surgery
  • Some procedures require prior authorization from your insurance
  • This process can take up to 2 weeks
Once your doctor recommends a procedure:
  • We’ll check with your insurance
  • Confirm if authorization is needed
  • Provide you with an estimated cost
Important to know:
  • Insurance determines where your procedure can take place
  • Cost estimates are not final bills
  • A deposit or payment may be required before surgery
After Your Procedure

Your surgery includes a “global period”, which means:

  • Follow-up visits related to your procedure are included
  • Your doctor will monitor your healing and recovery
Helpful Tip
Always check if your provider is in-network. Even if an office “accepts” your insurance, it may still be considered out-of-network, which can cost you more.
If you have any questions about your insurance, please don’t hesitate to ask. We’re here to help every step of the way.