I have Medicare insurance, and I will enter my insurance details when I make my appointment or register as a new patient. I am aware that currently My Heart Spark P.C. accepts Medicare plans. I also understand that I will be responsible for payment of any services I have not yet paid for, if any portion of the services I receive from My Heart Spark P.C. is not covered or reimbursed by my Medicare insurance.

I will enter my insurance details when I make my appointment or register as a new patient. I have Medicare Advantage insurance. I do not have Medicare insurance. I understand that Medicare Advantage insurance plans are not yet in use at My Heart Spark P.C., but hopefully soon they will be! I therefore am aware and I understand that I will be responsible for payment of any services I have not yet paid for, since My Heart Spark P.C. is not currently yet set up to accept Medicare Advantage insurance at this time.

I will enter my insurance details when I make my appointment or register as a new patient. I have private insurance (e.g., Aetna, Humana). I do not have Medicare or Medicare Advantage insurance. I understand that insurance plans from private insurance companies are not yet in use at My Heart Spark P.C., but hopefully soon they will be! I therefore am aware and I understand that I will be responsible for payment of any services I have not yet paid for, since My Heart Spark P.C. is not currently yet set up to accept private insurance at this time.

I will enter my insurance details when I make my appointment or register as a new patient. I have other health insurance. I do not have Medicare or United Health Medicare Advantage insurance or private insurance. I understand that my insurance plans are not yet in use at My Heart Spark P.C., but hopefully soon they will be! I therefore am aware and I understand that I will be responsible for payment of any services I have not yet paid for, since My Heart Spark P.C. is not currently yet set up to accept my insurance at this time.