INSURANCE OVERVIEW:
- Dr. Foye evaluates and treats patients who travel here from around the world, regardless of whether their health insurance plans are “In-Network” versus “Out-of-Network” with his office.
- No problem. Either way is fine. See details below.
- Just check with Dr. Foye’s office before you schedule and they can answer your insurance questions.
- In most cases, you can have an in-person office visit, and sitting-versus-standing coccyx x-rays, and a coccyx injection, all on the same day, if it is planned properly.
- Some patients may need pre-authorization from their insurance company before a coccyx injection, but most do not. Either way is fine. Again, just check with Dr. Foye’s office staff.
- Different health insurance plans have different co-pays, deductibles, or out-of-pocket costs. Again, Dr. Foye’s office staff can answer most of those questions for you.
- After reading the details below, then just send in your forms/paperwork, including your insurance information (insurance card, etc.). (Fax or mail these to Dr. Foye’s office.) Then call Dr. Foye’s office staff (973-972-2802) and they will help answer your questions and help you to receive expert medical care here.
INSURANCE, “In-Network”:
- Dr. Foye’s office is ~ In-Network nearly all versions of New Jersey Medicaid programs, New Jersey “Charity Care”, and “traditional” Medicare.
- (But if you have Medicare Advantage, which is “managed Medicare”, then see below for details and limitations.)
INSURANCE, “Out-of-Network”:
- Dr. Foye sees patients from around the country and from around the world via “Out-of-Network” (meaning that if your insurance company has not established a contract with Dr. Foye’s employer/university for the medical care that he provides… then Dr. Foye can still see you for evaluation and treatment here, but there is often an Out-of-Pocket cost paid by the patient to his university on the date of service).
- The following are Out-of-Network: Blue Cross Blue Shield, United Healthcare, Aetna US Healthcare, Oxford, Cigna, and others.
- Even if you have these or other insurance plans that may be “Out-Of-Network” with our office, there is good news for you: you can usually still be treated here.
- Our staff routinely works with patients who have these and other Out-of-Network insurance plans.
- The result is that most patients who are willing to travel here can indeed be treated here.
- Often you can be treated here even if you do not have out-of-network benefits.
- Our office staff here are very experienced at helping patients who come here from around the world.
- Out-of-Network Billing and costs: if you are Out-of-Network, then Dr. Foye’s employer/University will NOT bill your insurance company. Instead, our staff will give you a detailed RECEIPT that you can submit to your insurance company or your health savings account, if you want to see if they will reimburse you or count the payment towards your Out-of-Pocket deductible.) Most people find these costs to be very affordable and a terrific value for the time and expert level of medical care that is provided. As of 2026, the following are the typical amounts that Out-of-Network patients pay Out-of-Pocket on the date-of-service: Initial Visit: $278. Follow-Up Visit: $214. Coccyx injection: $740. (ganglion-impar + steroid injection = his most common injection). This information is being provided to you in advance, for price transparency.
- Our staff can answer your questions in advance of your visit, so that you have that information prior to your trip here.
- Just send in your paperwork and the office staff here will check it out for you and then they can go over it with you by phone. Click the icon below (on this page) for the paperwork that you need to send in to our office.
“MEDICARE ADVANTAGE” insurance (also called “Managed Medicare”): This is VERY different from “traditional” Medicare in TWO important ways.
- Unlike “traditional” Medicare, “Medicare Advantage” can (ironically) be a Disadvantage, since it usually has a much more restricted network of physicians within their plans. Thus, even though Dr. Foye is participating with “traditional” Medicare, he is probably not a member of your specific “Medicare Advantage” plan (especially since nationwide there are thousands of these Medicare Advantage plans that do not include Dr. Foye). Check with your specific plan to see if Dr. Foye is in-network, and if he is not in-network then check whether your plan covers medical care from non-participating (out-of-network) physicians. It is the patient’s responsibility to ask your Medicare Advantage plan whether they have included Dr. Foye as a “participating physician” within their network and whether your plan will pay for any out-of-network care.
- Also, unlike “traditional” Medicare, “Medicare Advantage” plans often require pre-authorization for procedures (such as the pain management injections that Dr. Foye provides). Thus, “Medicare Advantage” can again (ironically) be a Disadvantage because we are not able to start the pre-authorization process until you have your initial office visit, and then it can take a week or two for us to receive a reply regarding authorization. This means that even if Dr. Foye is participating (in-network) with your “Medicare Advantage” plan, you usually are still not able to have an injection until a few weeks after the initial office visit, which means that you will usually need to make an extra trip to his office in northern New Jersey for the injection.
- We are letting you know this in advance so that if you have “Medicare Advantage” then you are aware that your injection will typically not be done on the same day as your initial office visit here.
- If you are not sure whether your Medicare plan covers your care here, then please postpone submitting your paperwork until that is sorted out.
Insurance, x-rays:
- The sitting-versus-standing coccyx x-rays done here on campus are done through the outpatient part of University Hospital’s Radiology Department. From an insurance perspective the hospital is a totally different facility and is not part of Dr. Foye’s office.
- The hospital (like Dr. Foye’s office) is in-network with traditional Medicare, NJ Medicaid, and some other insurance companies.
- You can ask your insurance company whether “University Hospital, Newark” is in-network for your x-rays.
- Note that most other radiology centers fail to do the sitting-versus-standing coccyx x-rays properly, so it is usually very worthwhile to have them done here.
- As of 2026, the hospital charge is a few hundred dollars for the x-rays. (Contact the hospital for details.)
- There is also a charge for the Radiologist who reads the x-rays. As of 2026 this is less than $100.
For FORMS (paperwork) that patients need to fill out prior to making your appointment with Dr. Foye…
please click on this link: https://tailbonedoctor.com/forms/