Oak Street Health accepts a wide range of Medicare plans in 2025, including Original Medicare (Parts A & B), Medicare Advantage plans from major insurers like Aetna and UnitedHealthcare, and all standardized Medigap plans. If you’re dual-eligible for Medicare and Medicaid, you’ll likely qualify for extensive coverage with $0 premiums and copays. Plan acceptance varies by region, so it’s best to verify your specific coverage by calling (888) 812-1183. The full guide reveals significant 2025 policy updates.

Understanding Oak Street Health’s Medicare Acceptance

When maneuvering healthcare options as a Medicare beneficiary, you’ll find Oak Street Health offers extensive coverage acceptance across their nationwide network. Your Original Medicare (Parts A & B) serves as primary insurance at all locations, covering preventive services, wellness visits, and chronic condition management.

You’ll need Medicare Part B enrollment for outpatient care coverage, but you won’t face network restrictions that typically limit your choices with managed care plans. This flexibility allows you to maintain freedom in selecting Medicare-approved specialists while receiving primary care at Oak Street Health. For verification of your coverage, you can call their support team at (888) 812-1183.

For coverage options beyond basic Medicare, Oak Street accepts all standardized Medigap plans (A-N) where available, including popular choices like Plan G and Plan N. Oak Street Health also accepts many Medicare Advantage plans offered by private insurance companies.

Their verification system and support team can confirm your specific Medicare enrollment status instantly. Most patients find convenient access to services in their local neighborhoods, emphasizing Oak Street Health’s commitment to community-based healthcare.

Major Medicare Advantage Plans Accepted

Oak Street Health works with nationwide Medicare Advantage providers while maintaining specific regional plan variations.

You’ll find that major insurers like Aetna, UnitedHealthcare, Blue Cross Blue Shield, Humana, and Cigna offer coverage at Oak Street Health locations.

Aetna’s Medicare Advantage plans provide excellent coverage options with core benefits maintained across all their 2025 plans, including $0 monthly premiums and $0 primary care copays.

Your plan’s acceptance may vary depending on your state, with some locations offering broader insurance options than others. If you’re unsure about your coverage, you can call directly at (888) 812-1183 for verification. Since Oak Street Health specializes in care for adults on Medicare, their services are tailored for seniors who need comprehensive primary care.

Nationwide Network Providers

Five major Medicare Advantage carriers partner with Oak Street Health to provide extensive coverage for patients nationwide.

UnitedHealthcare offers HMO-POS and PPO plans with $0 premium options, while Humana provides Gold Choice PFFS plans featuring flexible network availability and $0 copays for primary care visits.

Aetna’s network includes Buy-Down premium plans and Chronic Condition SNPs with $0 deductible prescription coverage.

Blue Cross Blue Shield improves provider accessibility through their Medicare Advantage Protect PPO and Value-Based Insurance Design models, complemented by 24/7 telehealth services. If you’re having trouble finding your plan, you can contact their dedicated insurance support line at (888) 812-1183 for personalized assistance.

Cigna rounds out the nationwide coverage with their Flex Access PPO plans and Essential Rx Plus program.

These partnerships guarantee you’ll likely find an in-network Oak Street Health location regardless of which major Medicare Advantage plan you carry. Oak Street Health’s commitment to 24/7 patient support ensures you can access assistance whenever needed, regardless of your insurance plan.

Regional Plan Variations

With the expansion into new territories underway, Oak Street Health’s Medicare Advantage coverage varies markedly by region. The network is growing from 170 centers across 21 states in 2023 to a projected 300+ locations by 2026, including new facilities in Arkansas, Iowa, Kansas, and Virginia.

State-specific expansions bring customized Medicare Advantage options, like UnitedHealthcare plans H2406-061 in Arizona and H5322-042 in Georgia. Regional carriers such as MeridianComplete (Michigan) and VISTA Health Plan (Texas) complement nationwide insurers Aetna and Humana. The company offers integrated healthcare delivery through its newly launched OakWell joint venture with Interwell Health for patients with kidney disease.

Plan benefit differences are significant across locations, with some regions offering $0 monthly premiums for dual-eligible members. The company’s value-based care model focuses on quality outcomes rather than service volume, resulting in significant reductions in hospital admissions and emergency visits.

Further perks vary by state, including gym memberships, dental coverage, and vision benefits, while out-of-pocket maximums differ based on location and eligibility. CVS plans to introduce more co-branded plans between Aetna and Oak Street Health for 2025.

Original Medicare and Medigap Coverage Options

Oak Street Health fully accepts your Original Medicare Part B coverage for primary care services, with Part A benefits applying to hospital services through affiliated networks.

You’ll find that all Medicare Supplement (Medigap) plans work seamlessly with Oak Street facilities, helping to reduce your out-of-pocket costs for deductibles and coinsurance.

When coordinating your Medicare and Medigap coverage, you won’t need referrals for in-network specialist consultations, and you’ll maintain access to any Medicare-accepting hospital for inpatient care. The recent expansion of mental health care resources through Medicare benefits offers additional support options for Oak Street Health patients. Be aware that the Part A deductible has increased to $1,676 for inpatient hospital services in 2025. Oak Street Health specializes in providing comprehensive care to Medicare-eligible adults, with patient relation managers available to help you understand your coverage benefits.

Original Medicare and Medigap Coverage Options

Understanding the relationship between Original Medicare and Medigap policies creates a foundation for making informed healthcare decisions during retirement.

Your Original Medicare enrollment provides baseline coverage for inpatient (Part A) and outpatient (Part B) services, but leaves significant cost gaps. Medigap benefits fill these gaps by covering deductibles, coinsurance, and even emergency care abroad.

In 2025, you’ll pay $185 monthly for Part B plus $150-$300 for Medigap coverage, depending on your plan choice. Plan G remains popular, covering all costs except the $257 Part B deductible, while Plan N offers lower premiums with modest copays. With Original Medicare, there is no out-of-pocket maximum to limit your annual healthcare expenses. Oak Street Health proudly accepts all forms of Medicare and their associated Medigap plans to ensure comprehensive coverage for patients.

Part B Acceptance Details

Maneuvering Medicare Part B coverage at Oak Street Health centers requires knowing the specific acceptance details that impact your care options.

All Oak Street Health locations fully accept Medicare Part B as your primary insurance for outpatient services, with no network restrictions beyond clinic availability.

To establish Part B eligibility, you’ll need active enrollment through the Social Security Administration before seeking care.

While most centers accept Part B alone, some require enrollment in both Parts A and B.

Your coverage includes extensive Part B services like preventive care, medically necessary doctor visits, diagnostic services, and limited prescription drugs.

For 2025, expect a $185 monthly premium, $257 annual deductible, and 20% coinsurance.

If you’ve enrolled in a Medigap plan, it’ll help cover these out-of-pocket costs at Oak Street Health.

You may also qualify for a Special Enrollment Period if you have specific circumstances like loss of employer coverage, allowing you to enroll in Medicare Part B without waiting for the General Enrollment Period.

Supplemental Plan Coordination

Beyond basic Medicare Part B coverage, you’ll find valuable financial protection through supplemental insurance options at Oak Street Health. The practice accepts all standardized Medigap plans, which cover the 20% coinsurance, deductibles, and other out-of-pocket costs that Original Medicare doesn’t.

When comparing Medigap coverage options, keep in mind that benefits are standardized while premiums vary by insurer. Plans like G and N offer strong protection against unexpected healthcare expenses. These supplements greatly reduce your financial responsibility for hospital stays and doctor visits at Oak Street Health.

Keep in mind that Medigap enrollment timing matters—you’ll have a 6-month window after enrolling in Part B to secure coverage without medical underwriting.

Unlike Medicare Advantage, Medigap works alongside your Original Medicare coverage, giving you nationwide access to providers. With Oak Street Health now part of the CVS Health network, patients may find more integrated care solutions across their extensive medical centers in 21 states.

Medicare-Medicaid Dual Eligibility Coverage

While managing health insurance can be complex, dual eligibility offers significant advantages for qualifying Oak Street Health patients. If your income is under $21,000 annually, you may join the 42% of Oak Street Medicare patients who receive dual eligibility benefits, including $0 premiums, $0 copays, and expanded services like dental and vision care.

You’ll benefit from enrollment flexibility that allows quarterly plan changes outside standard Medicare periods. Oak Street’s Dual Special Needs Plans (D-SNPs) provide integrated care coordination that has reduced hospitalizations by 50% and emergency visits by 52%. The process to become a patient is straightforward and open to individuals eligible for Medicare and Medicaid.

These plans cover services traditional Medicare doesn’t, including transportation, home health aides, and sometimes meal delivery. The Dual Eligibles program serves approximately 12 million Americans who qualify for both programs nationwide. For qualifying seniors, disabled individuals, and those with end-stage renal disease, dual coverage can reduce out-of-pocket costs by 30-50% compared to standalone Medicare.

How to Verify Your Insurance Plan Acceptance

Verifying that Oak Street Health accepts your insurance plan represents a key step before scheduling your initial appointment.

Patient Relations Managers can provide thorough insurance verification assistance, helping you understand coverage details and out-of-pocket costs before your visit.

Dedicated staff members help navigate your insurance coverage so you’ll know exactly what to expect financially.

During patient registration, you’ll need to submit accurate insurance information, including policy numbers and group details.

Keep in mind that errors can delay claim processing by over 60 days.

• Contact a Patient Relations Manager directly via phone or email for personalized verification assistance
• Submit complete insurance details during registration, including secondary coverage
• Prepare to make any required co-payments at the time of service
• Utilize your insurer’s online provider portal to confirm Oak Street Health’s network participation status

Regional Variations in Medicare Plan Acceptance

Because Medicare Advantage plan availability differs considerably across regions, Oak Street Health’s insurance acceptance varies by location. Urban centers in Chicago, Philadelphia, and New York City typically accept 20-30 Medicare Advantage plans per location, with approximately 90% coverage of regional options.

Rural clinics in Kansas and Iowa partner with localized insurers like Healthy Blue and Wellcare to address regional disparities.

State-specific variations are significant: Illinois, Michigan, and Texas locations offer broader carrier options including Blue Cross Blue Shield and Cigna, while newer markets in Arkansas and Kansas work with regional insurers.

Urban access generally includes more extensive benefits—95% of urban-accepted plans cover telehealth compared to 70% in rural areas.

If you’re dual-eligible for Medicare and Medicaid, check your specific location’s acceptance policies, as coverage varies by state Medicaid programs.

Special Insurance Programs and Partnerships

Oak Street Health extends beyond standard Medicare Advantage acceptance through specialized insurance programs and strategic partnerships designed to optimize patient care.

These collaborations focus on managing specific chronic conditions while reducing costs and improving outcomes through value-based models.

• Kidney Heroes™ Program with Endeavor Health reduces hospitalizations by 42% for chronic kidney disease patients through predictive analytics and specialized care teams.
• Oncology Navigation via Thyme Care connects Medicare Advantage members to network specialists, projecting $2.5M in savings through coordinated treatment.
• Chronic Condition Management partnerships with Jefferson Health Plans and others address diabetes, hypertension, and neurological disorders.
• Real-Time Care Coordination through Bamboo Health’s alert system across 2,500+ hospitals helps prevent readmissions and improve CMS Star Ratings.

These specialized partnerships enable Oak Street to deliver extensive care for complex chronic programs while maintaining cost efficiency.

Transportation and Support Services Coverage

While maneuvering healthcare needs often presents challenges for seniors, transportation barriers can make accessing care particularly difficult. At Oak Street Health, you’ll find extensive transportation coverage options that vary based on your insurance plan.

Oak Street Health’s green van service operates independently of insurance for eligible patients with mobility challenges. Their care teams coordinate with in-clinic specialists to reduce your need for external travel, while social workers help connect you to further community transportation resources.

Changes to Insurance Acceptance for 2025

As 2025 approaches, significant updates to Oak Street Health’s insurance acceptance are reshaping coverage options for seniors. The provider has expanded its Medicare Advantage footprint while prioritizing Aetna partnerships following the CVS acquisition. These insurance plan changes impact which plans you’ll be able to use at Oak Street locations in your state.

• Oak Street has added four new states (Arkansas, Iowa, Kansas, and Virginia) with region-specific MA partners.
• Co-branded Aetna/Oak Street plans launched for 2025 enrollment with $0 premiums and PCP copays.
• D-SNP options expanded across five new states for dual-eligible Medicare/Medicaid members.
• CMS policy changes have resulted in the $2,000 annual Part D out-of-pocket maximum and prioritized plans with lower insulin costs.

Frequently Asked Questions

Does Oak Street Health Accept Private or Employer Health Insurance?

No, Oak Street Health doesn’t accept private insurance options or employer coverage details as primary insurance.

They exclusively work with Medicare plans (Original Medicare Part B, Medicare Advantage, and Medicare Supplement plans).

If you have private or employer-sponsored health insurance, you’ll need to convert to an eligible Medicare plan to receive care.

Their Patient Relations Managers can help you shift to an accepted plan during Special Enrollment Periods if needed.

Can Family Members Without Medicare Receive Care at Oak Street Health?

No, family members without Medicare can’t receive care at Oak Street Health.

The clinic exclusively serves Medicare-eligible adults of 65 years and older and doesn’t provide non-Medicare services.

Your family member eligibility depends entirely on having Medicare as their primary insurance.

If your loved ones don’t have Medicare, they’ll need to seek care elsewhere, such as CVS MinuteClinics which serve all demographics.

Oak Street’s entire care model is specifically designed for Medicare patients.

Are Oak Street Health’s Medication Services Covered by Medicare?

Yes, Oak Street Health’s medication services are covered by Medicare.

Your medication coverage includes Part B for outpatient medication management and preventive services, while Medicare Advantage (Part C) plans offer extensive prescription assistance.

You’ll benefit from the $2,000 annual out-of-pocket cap for Part D prescription costs and $35/month insulin copay cap.

Oak Street Health also partners with CVS Health to provide expanded pharmacy benefits and offers prescription assistance through their 24/7 support line.

How Often Should Patients Reverify Their Insurance Acceptance?

You should reverify your insurance acceptance before every appointment at Oak Street Health to account for contract changes.

Furthermore, conduct insurance re-verification annually during Medicare’s Open Enrollment Period (October 15-December 7).

Don’t wait for problems—immediately update your patient insurance information after qualifying life events like marriage or relocation, when switching between Medicare plans, or if you receive insurer notifications about network changes.

For complex cases, Oak Street Health’s Patient Relations Managers can assist you.

Does Medicare Cover Oak Street Health’s Preventive Screening Programs?

Yes, Medicare fully covers Oak Street Health’s preventive screening programs.

You’ll receive annual wellness visits, cancer screenings (mammograms, colonoscopies), cardiovascular assessments, diabetes testing, and vaccinations at no cost when criteria are met.

Medicare Advantage plans must cover these same preventive care services, with many offering improved benefits.

Your preventive care at Oak Street Health locations is typically covered with $0 copays as long as you’re enrolled in Medicare Part B or a Medicare Advantage plan.