DR. SHEILA CONCEPCION O.D.
Accepted Insurance for NPI 1740548627
Optometrist in Philadelphia, PA
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
DR. SHEILA CONCEPCION O.D., a optometrist provider in Philadelphia, PA, is listed as in-network for 880 health insurance plans from 12 insurance companies, led by Ambetter Health, Oscar Health Maintenance Organization of Florida and Blue Cross and Blue Shield of Texas. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
Ambetter Health
Clarity Silver
Clarity VALUE Silver
Complete Gold + Vision + Adult Dental
Complete Gold
Complete VALUE Gold
Elite Bronze + Vision + Adult Dental
Elite Bronze
Elite VALUE Bronze
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental
Enhanced Diabetes Care Silver with $0 Drug Options
Everyday Bronze + Vision + Adult Dental
Everyday Bronze
Everyday Gold + Vision + Adult Dental
Everyday Gold
Focused Silver + Vision + Adult Dental
Focused Silver
Focused VALUE Silver
Standard Expanded Bronze + Vision + Adult Dental
Standard Expanded Bronze VALUE
Standard Expanded Bronze
Standard Gold + Vision + Adult Dental
Standard Gold VALUE
Standard Gold
Standard Silver + Vision + Adult Dental
Standard Silver VALUE
Standard Silver
Thrive Silver
Ambetter from Superior HealthPlan
Complete VALUE Gold
Focused VALUE Silver + Vision + Adult Dental
Focused VALUE Silver
Standard Gold VALUE
Standard Silver VALUE + Vision + Adult Dental
Standard Silver VALUE
Ambetter of Alabama
Complete Gold + Vision + Adult Dental
Complete Gold
Elite Bronze + Vision + Adult Dental
Elite Bronze
Elite Gold + Vision + Adult Dental
Elite Gold
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental
Enhanced Diabetes Care Silver with $0 Drug Options
Everyday Bronze + Vision + Adult Dental
Everyday Bronze
Focused Silver + Vision + Adult Dental
Focused Silver
Standard Expanded Bronze + Vision + Adult Dental
Standard Expanded Bronze
Standard Gold + Vision + Adult Dental
Standard Gold
Standard Silver + Vision + Adult Dental
Standard Silver
Blue Cross Blue Shield of Wyoming
BlueSelect Bronze Basic
BlueSelect Bronze Core
BlueSelect Expanded Bronze Standard without Kid's Dental
BlueSelect Gold Core
BlueSelect Gold HealthPlus
BlueSelect Gold Standard without Kid's Dental
BlueSelect Silver Classic without Kid's Dental
BlueSelect Silver Classic
BlueSelect Silver HealthPlus without Kid's Dental
BlueSelect Silver HealthPlus
BlueSelect Silver Standard without Kid's Dental
Blue Cross and Blue Shield of Louisiana
Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible
Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits
Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits
Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible
Blue Max Copay (PCP) 60/40 $6000 Standardized
Blue Max Copay (PCP) 75/55 $2000 Standardized
Blue Saver 60/40 $6100
Blue Saver 90/70 $3400
Blue Cross and Blue Shield of Montana
Blue Focus Bronze POS? 205
Blue Focus Bronze POS? 705
Blue Focus Bronze POS? Standard
Blue Focus Gold POS? 207
Blue Focus Gold POS? 902
Blue Focus Gold POS? Standard
Blue Focus Silver POS? 206
Blue Focus Silver POS? 903
Blue Focus Silver POS? Standard
Blue Preferred Bronze PPO? 201
Blue Preferred Bronze PPO? 202
Blue Preferred Bronze PPO? Standard
Blue Preferred Gold PPO? 204
Blue Preferred Gold PPO? 901
Blue Preferred Gold PPO? Standard
Blue Preferred Security PPO? 200
Blue Preferred Silver PPO? 203
Blue Preferred Silver PPO? 308
Blue Preferred Silver PPO? Standard
Blue Cross and Blue Shield of Oklahoma
Blue Advantage Bronze PPO? 202
Blue Advantage Bronze PPO? 203
Blue Advantage Bronze PPO? Standard
Blue Advantage Gold PPO? 309
Blue Advantage Gold PPO? 604
Blue Advantage Gold PPO? Standard
Blue Advantage Silver PPO? 204
Blue Advantage Silver PPO? 501
Blue Advantage Silver PPO? Standard
Blue Preferred Bronze PPO? Standard
Blue Preferred Gold PPO? Standard
Blue Preferred Security PPO? 200
Blue Preferred Silver PPO? Standard
MyBlue Bronze HMO? 902
MyBlue Bronze HMO? 904
MyBlue Bronze HMO? Standard
MyBlue Gold HMO? 704
MyBlue Gold HMO? 804
MyBlue Gold HMO? Standard
MyBlue Silver HMO? 705
MyBlue Silver HMO? 803
MyBlue Silver HMO? Standard
Blue Cross and Blue Shield of Texas
Blue Advantage Bronze HMO? 204
Blue Advantage Bronze HMO? 301
Blue Advantage Bronze HMO? Standard
Blue Advantage Gold HMO? 206
Blue Advantage Gold HMO? 603
Blue Advantage Gold HMO? Standard
Blue Advantage Plus Bronze? 303
Blue Advantage Plus Bronze? 305
Blue Advantage Plus Bronze? Standard
Blue Advantage Plus Gold? 203
Blue Advantage Plus Gold? 803
Blue Advantage Plus Gold? Standard
Blue Advantage Plus Silver? 202
Blue Advantage Plus Silver? 605
Blue Advantage Plus Silver? Standard
Blue Advantage Security HMO? 200
Blue Advantage Silver HMO? 205
Blue Advantage Silver HMO? 801
Blue Advantage Silver HMO? Standard
MyBlue Health Bronze? 402
MyBlue Health Bronze? Standard
MyBlue Health Gold? 403
MyBlue Health Gold? Standard
MyBlue Health Silver? 405
MyBlue Health Silver? Standard
Highmark Blue Cross Blue Shield Delaware
my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits
my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision
my Blue Access Select PPO Bronze 3800
my Blue Access Select PPO Bronze 9200
my Blue Access Select PPO Gold 0 + Adult Dental and Vision
my Blue Access Select PPO Gold 0
my Blue Access Select PPO Gold 1700 HSA
my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision
my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision
my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision
my Blue Access Select PPO Standard Bronze 7500
my Blue Access Select PPO Standard Gold 2000 + Adult Dental and Vision
my Blue Access Select PPO Standard Gold 2000
my Blue Access Select PPO Standard Platinum 0
my Blue Access Select PPO Standard Silver 6000
Highmark Blue Cross Blue Shield West Virginia
my Blue Access WV Major Events PPO Catastrophic 10600 - 3 Free PCP Visits
my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision
my Blue Access WV PPO Bronze 3800
my Blue Access WV PPO Bronze 9200
my Blue Access WV PPO Gold 0 + Adult Dental and Vision
my Blue Access WV PPO Gold 0
my Blue Access WV PPO Gold 1700 HSA
my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision
my Blue Access WV PPO Premier Gold 0
my Blue Access WV PPO Premier Silver 0 + Adult Dental and Vision
my Blue Access WV PPO Premier Silver 0
my Blue Access WV PPO Standard Bronze 7500
my Blue Access WV PPO Standard Gold 2000 + Adult Dental and Vision
my Blue Access WV PPO Standard Gold 2000
my Blue Access WV PPO Standard Silver 6000
Oscar Health Maintenance Organization of Florida
Bronze Classic 4700 | with AdventHealth
Bronze Classic 4700
Bronze Classic Standard | with AdventHealth
Bronze Classic Standard
Bronze Elite + PCP Saver Plus | with AdventHealth
Bronze Elite + PCP Saver Plus
Bronze Simple Breathe Easy with Enhanced COPD Benefits
Bronze Simple Chronic Care CKM
Bronze Simple Diabetes
Gold Classic Standard | with AdventHealth
Gold Classic Standard
Gold Elite Saver Plus | with AdventHealth
Gold Simple | with AdventHealth
Gold Simple
Silver Classic Standard | with AdventHealth
Silver Classic Standard
Silver Elite | with AdventHealth
Silver Elite
Silver Simple Breathe Easy with Enhanced COPD Benefits
Silver Simple Chronic Care CKM | with AdventHealth
Silver Simple Chronic Care CKM
Silver Simple Diabetes | with AdventHealth
Silver Simple Diabetes
Silver Simple PCP Saver | with AdventHealth
Silver Simple PCP Saver
Silver Simple Women's Health with Menopause Benefits
Providence Health Plan
Connect 1500 Gold
Connect 6000 Silver
Connect 9800 Bronze
HSA Qualified 7500 Bronze - Choice Network
HSA-E Qualified 7500 Bronze - Signature Network
Providence Oregon Standard Bronze Plan - Choice Network
Providence Oregon Standard Bronze Plan - Signature Network
Providence Oregon Standard Gold Plan - Choice Network
Providence Oregon Standard Gold Plan - Signature Network
Providence Oregon Standard Silver Plan - Choice Network
Providence Oregon Standard Silver Plan - Signature Network
Coverage Questions FAQs
Common questions about this provider’s insurance participation, answered from the CMS Health Insurance Marketplace and Medicare enrollment files.
What insurance does DR. SHEILA CONCEPCION O.D. accept?
Marketplace files for the 2026 plan year list DR. SHEILA CONCEPCION O.D. as in-network for 880 plans from 12 insurance companies. The largest networks are Ambetter Health (27 plans), Oscar Health Maintenance Organization of Florida (26 plans), Blue Cross and Blue Shield of Texas (25 plans), followed by 9 more companies. The full list above shows each plan's metal level, network type, and plan IDs.
Is DR. SHEILA CONCEPCION O.D. enrolled in Medicare?
The CMS enrollment files for this NPI show a PECOS enrollment record, which certifies the provider to order, refer, and prescribe for Medicare beneficiaries. The files do not currently show a Medicare assignment indicator; verify Medicare participation directly with the practice.
What network types does DR. SHEILA CONCEPCION O.D. participate in?
The accepted plans include 84 HMO plans, 72 PPO plans, 29 EPO plans and 18 POS plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists. PPO (Preferred Provider Organization) plans cover out-of-network care at a higher cost and do not require referrals. EPO (Exclusive Provider Organization) plans cover network providers only, generally without referral requirements. POS (Point of Service) plans combine HMO-style referrals with partial out-of-network coverage.
Where does this insurance data come from and how current is it?
Plan participation is compiled from the official CMS Health Insurance Marketplace public use files for the 2026 plan year and refreshed as CMS publishes updated files. Networks change during the year, so always verify coverage with the insurance company or the provider's office before scheduling care.
