Health Insurance Plans Accepted at Sarasota Memorial Locations
Below is information on the Medicare/Medicaid, private and other health insurance plans accepted at Sarasota Memorial Hospital-Sarasota Campus, Sarasota Memorial Hospital-Venice Campus, and our network of outpatient and urgent care centers. This list is subject to change at any time.
SMH-Venice Notice
Some SMH-Venice payer contracts are still pending due to federal regulatory requirements and certain payer conditions; these pending contracts are clearly noted below. While SMH-Venice may not yet accept all insurance plans for routine or scheduled services, we are working as quickly as possible to finalize insurer contracts and provide unimpeded access to our new acute-care hospital.
Be sure to revisit this webpage over the coming weeks as we continue to work with regulatory agencies and health insurance companies to expand our coverage network for SMH-Venice.
Confirm Coverage
Because health insurance coverage can differ from plan to plan, even under the same insurer, we highly recommend contacting your insurance company’s member services for information specific to your plan’s coverage and to confirm your plan’s in-network providers and facilities.
Except in emergency situations, using an out-of- network facility can result in a patient being responsible for a larger portion of a hospital bill.
Emergency Care
You have the right to seek emergency services and care anywhere they are provided, regardless of insurance.
In a medical emergency, patients may seek emergency care at any of our 3 ER locations — SMH-Sarasota, SMH-Venice or our freestanding North Port ER — regardless of insurance coverage or status.
Medicare Plans
The following Medicare plans are currently accepted at SMH-Sarasota and Sarasota Memorial’s network of outpatient and urgent care centers:
The following Medicare plans are currently accepted at SMH-Venice for routine and scheduled services:
Sarasota Memorial and our outpatient and urgent care centers may be out-of-network providers for any other Medicare Replacement/Advantage HMO, PPO or POS plans not listed above. If you have any questions about your plan coverage, contact your Medicare Replacement or Medicare Advantage health insurance company directly.
Health Plans We Accept
Unless indicated with a noted exception of "pending" or "excluded," the health insurance plans listed below are accepted at SMH-Venice, SMH-Sarasota and our network of outpatient and urgent care centers. This list is subject to change at any time.
Aetna
4630 Woodland Corporate Blvd.
Tampa, FL 33614
Website: aenta.com
Aetna Signature Administrators
Commercial HMO
Commercial PPO
Marketplace/Exchange - QHP
International PPO
Medical Mutual of Ohio
Medicare Advantage HMO, PPO, and POS
Workers Compensation
(We do not accept Limited Benefit Plans, Short Term Medical Plans or discount cards administered by Aetna.)
Open Enrollment
Medicare Open Enrollment
Medicare open enrollment for 2021 ended Dec. 7. Click here for more important information about Medicare Open Enrollment.
We are not a network provider for Medicare Select supplemental plans. Medicare Select members may choose Sarasota Memorial for their care, but depending on each plan’s benefits, you may be responsible for the Part A deductible for non-emergency hospital care. Check with your insurance company, as some will pay that deductible when providers are not in network.
Health Insurance Marketplace / Exchange Open Enrollment
Open enrollment for the Health Insurance Exchange / Marketplace for 2021 is under way: It began Nov. 1, 2021 and will run to Jan. 15, 2022. When choosing a health plan, be sure visits to your physicians and hospital of choice are covered under the plan. Click here for more information.
AmeriGroup (see Simply Healthcare)
P.O. Box 61010
Virginia Beach, VA 23466
Website: amerigroup.com
Medicaid HMO (SMH-Venice Pending)
Florida Healthy Kids (SMH-Venice Pending)
AvMed
9400 S. Dadeland Blvd.
Miami, FL 33156
Website: avmed.org
Commercial PPO (SMH-Venice Pending)
(All outpatient services require a pre-authorization.)
Beacon Health Options (formerly Value Options)
240 Corporate Blvd.
Norfolk, VA 23502
Website: beaconhealthoptions.com
Behavioral Health (SMH-Venice Pending)
Blue Cross & Blue Shield of Florida (BCBS)
532 Riverside Ave.
Jacksonville, FL 32231
Website: floridablue.com
Health Options HMO
Commercial NWB
Commercial PPO/PPC
Traditional PPO
Medicare HMO/PPO
Marketplace/Exchange - QHP: BlueOptions PPO, BlueCare HMO, myBlue HMO and BlueSelect
Bright HealthCare (All locations effective Jan. 1, 2022)
800 Norman Center Dr., Suite 1200
Minneapolis, MN 55437
Website: brighthealthcare.com
Marketplace/Exchange - QHP
Medicare PPO
Compass Health Systems
(Behavioral Health)
1065 NE 125 St., Suite 206
Miami, FL 33161
Website: compasshealthsystems.com
Behavioral Health (SMH-Venice Excluded)
Coventry Healthcare/First Health
6720-B Rockledge Dr., Suite 800
Bethesda, MD 20817
Commercial HMO
Commercial POS
Commercial PPO
Workers Compensation
Gulf Coast Provider Network (GCPN)/Gulf Coast Provider Select
1700 South Tamiami Trail
Sarasota, FL 34239
Website: gulfcoastprovider.net
Interplan Health Group (HealthSmart)
222 West Las Colinas Blvd., Suite 500N
Irving, TX 75039
Website: healthsmart.com
Commercial PPO (SMH-Venice Pending)
Workers Compensation (SMH-Venice Pending)
Magellan Behavioral Health
855 SW 78th Ave.
Plantation, FL 33324
Website: magellanassist.com
Summit Network (SMH-Venice Excluded)
Pinnacle Network (SMH-Venice Excluded)
Molina Healthcare
8300 NW 33rd St.
Doral, FL 33122
Website: molinahealthcare.com
Medicaid HMO (SMH-Venice Excluded)
Serious Mental Illness Plan (SMH-Venice Excluded)
Oscar Health Insurance
75 Varick St,
New York, NY 10013
Website: hioscar.com
Marketplace/Exchange – QHP
Red Card Payer Alliance (NON-PAR)
We do not accept any insurance that features the Red Card Payer Alliance logo on its card.
Rockport Healthcare Group
50 Briar Hollow Ln. #515W
Houston, TX 77027
Workers Compensation
Select locations (SMH-Venice Excluded)
Simply Healthcare (see AmeriGroup)
9250 West Flagler St.
Miami, FL 33174
Website: simplyhealthcareplans.com
Clear Health Alliance Medicaid HMO (SMH-Venice Pending)
(We do not participate in the Better Health product.)
Staywell WellCare (see Sunshine State)
(Effective Oct. 1, 2021, Staywell Wellcare Medicaid and Medicaid-related product members became Sunshine State Health Plan members; see Sunshine State info below.)
1323 W. Busch Blvd.
Tampa, FL 33612
Website: wellcare.com
Children's Medical Services Health Plan
Medicaid HMO
Florida Healthy Kids
Serious Mental Illness
Sunshine State Health Plan
P.O. Box 3070
Farmington, MO 63640
Website: sunshinehealth.com
Child Welfare Specialty Plan
Children’s Medical Services Health Plan
Serious Mental Illness Plan
Medicaid HMO
Florida Healthy Kids Plan
(We do not participate in Ambetter, Allwell, and WellCare Medicare products.)
TRICARE East Region (SMH-Venice Pending)
P.O. Box 8923
Madison, WI 53707-8923
Humama Military Website: humanamilitary.com
Tricare Website: tricare.mil
United Behavioral Health (UHC/Optum)
11000 Optum Circle
Eden Prairie, MN 55344
Website: optum.com
Behavioral Health (SMH-Venice Excluded)
UnitedHealthcare
3000 Bayport Dr., Ste. 1170
Tampa, FL 33634
Website: myuhc.com
Commercial HMO
Commercial PPO
Exchange - QHP – Compass
Medicare HMO/PPO
(We do not participate in the Medicaid HMO product)
NOTE: Sarasota Memorial does NOT accept: Short Term Benefit Plans administered by UnitedHealthcare or any plan that does not meet the minimum essential coverage requirements as stated by the Affordable Care Act (ACA). Commonly referred to as “Limited Benefit Plans” and “Discount Plans,” these types of plans are not regulated by the ACA; they are often listed on member insurance cards as ALL PremierChoice, Premier MED, Short Term Medical or TriTerm Medical. This may include policies/plans marketed as Freedom Life, Golden Rule or Bind.
USA Managed Care (SMH-Venice Excluded)
5301 Southwest Parkway
Suite 425
Austin, TX 78735
Website: usamco.com
Vivida Health
6630 Orion Dr., Ste. 203
Fort Myers, FL 33912
Website: vividahealth.com
Medicaid HMO
Please note: Sarasota Memorial's freestanding ER in North Port is part of Sarasota Memorial Hospital-Sarasota Campus. It is not an urgent care center. Services and care provided at the facility are billed at hospital emergency department rates. Florida's Agency for Health Care Administration (AHCA) makes available data on hospital prices and performance at Pricing.FloridaHealthFinder.gov.