CARL JON BUCHHOLZ MD
Accepted Insurance for NPI 1629631908
Surgery in Mount Airy, NC

Q: What managed care network types are accepted by this provider?

CARL JON BUCHHOLZ MD is enrolled across the following managed care network types: HMO, POS, PPO. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.

NPI Status: Active since April 22, 2019

Contact Information

1016 S SOUTH ST
MOUNT AIRY, NC
ZIP 27030
Phone: (336) 783-8900
Fax: (336) 786-3778

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with CARL JON BUCHHOLZ MD, a practicing surgery professional in Mount Airy, NC. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 49 individual coverage options managed by medical networks, including networks like Blue Cross and Blue Shield of NC, and UnitedHealthcare. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

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Fitler by Network Type

Blue Cross and Blue Shield of NC

Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060004

Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060031

Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060059

Blue Advantage Bronze Standard | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060052

Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060018

Blue Advantage Gold Standard A | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060050

Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060028

Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060002

Blue Advantage Silver Standard | Nationwide Doctors

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PPO Tier

Accepted Plan ID Variations

11512NC0060051

Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430009

Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430008

Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430010

Blue Care Bronze Standard | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430003

Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430004

Blue Care Gold Standard A | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430001

Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430007

Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430005

Blue Care Silver Standard | Statewide Doctors

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: HMO Tier

Accepted Plan ID Variations

11512NC0430002

Blue Value Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010007011512NC0100071

Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010001211512NC0100054

Blue Value Bronze HSA Eligible | Integrated | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010007911512NC0100080

Blue Value Bronze Standard | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010007411512NC0100077

Blue Value Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010000911512NC0100034

Blue Value Gold Standard A | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010007211512NC0100075

Blue Value Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010001111512NC0100044

Blue Value Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010006411512NC0100065

Blue Value Silver Standard | Limited Statewide Doctors

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: POS Tier

Accepted Plan ID Variations

11512NC010007311512NC0100076

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030033

UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030026

UHC Bronze Standard (No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030030

UHC Bronze Standard+ Dental + Vision (No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0060005

UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030040

UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0060007

UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030035

UHC Gold Standard (No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030022

UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030039

UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0060006

UHC Silver Standard (No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030027

UHC Silver Value ($0 Virtual Urgent Care, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0030020

UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NON-PREFERRED Tier

Accepted Plan ID Variations

54332NC0060004

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does CARL JON BUCHHOLZ MD accept?

This provider accepts health insurance plans managed by the following insurance companies: Blue Cross and Blue Shield of NC, UnitedHealthcare. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

Yes, registry files confirm this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. Additionally, the provider is officially enrolled in the PECOS program (Provider Enrollment, Chain, and Ownership System), verifying that they are certified to order, refer, or prescribe services to Medicare beneficiaries.

What managed care network types are accepted by this provider?

CARL JON BUCHHOLZ MD is enrolled across the following managed care network types: HMO, POS, PPO.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.
POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.