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Self-Pay & Fee Assessment

Payment is expected at the time of service for the visit balance. Our Health Centers accept cash, credit card, check or money order payments.

If there are out of pocket expenses for your visit, most services are based on a sliding fee scale which is based upon your household size and income. If you have specific questions please call any of our Health Centers.

Family Planning Benefit Program

We have staff on hand who can help you apply for free services through the Family Planning Benefit Program (FPBP). To qualify for FPBP you must:

  • Be a New York State resident
  • Be a male or female of childbearing age (including teens and college students)
  • Meet income guidelines
  • Be able to have children

If you meet the requirements, this New York State program will cover your birth control-related visits. The plan will also cover most prescriptions written for birth control. FPBP is not comprehensive health insurance, and will not cover all types of visits.

Surprise Bill Policy

PPNCNY accepts many forms of health insurance (see below) and will bill insurance companies as a courtesy to our patients.

However, it is the responsibility of patients to determine whether our Health Centers accept their health insurance and the services covered by their policy. Patients will be billed for any outstanding balance not covered by insurance.

For more information about surprise bills, or to contact our Billing Department, please review our Surprise Bill Policy.

Your Rights & Protections Against Surprise Medical Bills

Good Faith Estimate

Uninsured and/or self-pay patients are entitled to request a Good Faith Estimate in accordance with The Department of Treasury,  Labor and Health and Human Services.

The good faith estimate is an estimate and subject to change , the information provided in the good faith estimate are estimates and not the final overall total charges. Additional items and/or services that are not in the good faith estimate may be recommended by the rendering provider as part of the course of care, that must be scheduled separately and are not reflected in the good faith estimate. You have the right to initiate the patient-provider dispute resolution process if the actual billed charges are $400 more than the expected charges included in   the good faith estimate. The good faith estimate is not a contract and does not require the uninsured (or self- pay) individual to obtain the items and services from any of the providers or facilities identified on the good faith estimate.

Good Faith Estimate Disclaimer

Insurance Plans Accepted

With or without insurance, you can always come to us for your health care. If you plan on using insurance, you must bring in your insurance card.  We will verify your coverage at every visit. Co-pays and deductible amounts are due at time of service.

Accepted Health Insurance

Key:

Only Plattsburgh, Malone, & Saranac Lake Health Centers are in network

Canton, Lowville, Ogdensburg & Watertown Health Centers are in network

3 Must say "MVP" on the card

4 Only Plattsburgh, Malone, & Saranac Lake Health Centers are in network

Not accepted by all providers at PPNCNY, please check with Health Center staff before appointment to make sure insurance is accepted.

You will need a Prior Authorization to use Tricare Prime at PPNCNY locations. You MUST have Prior Authorization before we can bill your insurance or you will need to pay out-of-pocket. Please make sure to visit the Tricare website for more information and to request a Prior Authorization before your appointments.

  • Aetna Commercial
  • Blue Shield of North Eastern New York1
  • CDPHP Commercial2,5
  • CDPHP Medicaid Managed Care2,5
  • Cigna-MVP3
  • Empire Plan NYSHIP
  • Emblem/GHI Commercial
  • Empire Blue Cross Blue Sheild4,5
  • Excellus Commercial
  • First Health (JPO)
  • MagnaCare Commercial and Medicaid Managed Care
  • Medicaid/FPBP
  • Medicare5
  • Martin's Point5
  • Multiplan (JPO)
  • MVP Commercial and Medicaid Managed Care
  • POMCO
  • St. Lawrence - Lewis County (JPO)
  • Tricare Standard
  • Tricare Prime6
  • United Health Care Commercial and Medicaid Managed Care, Child Health Plus, Family Health Plus
  • Wellcare Medicaid Managed Care