Alyssa Lane
Vanderbilt University Medical Center (VUMC) is an out-of-network participant in several insurance plans, although some insurance carriers include Vanderbilt in their individual plans. Accepted insurance plans vary across different Vanderbilt facilities, including the Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt Bedford Hospital, and Vanderbilt My Health Walk-In Clinics. Notably, VUMC is excluded from specific plans, such as Blue Cross Blue Shield Tennessee Medicare Advantage and UnitedHealthcare COMPASS. Vanderbilt also offers its health plan to employees, with a $100 monthly fee for spouses who have access to separate employer-provided coverage.
| Characteristics | Values |
|---|---|
| Insurance plans accepted by Vanderbilt University Medical Center | Several insurance carriers include Vanderbilt in their individual plans. However, Vanderbilt may not participate in all products offered by an insurance carrier. |
| Insurance plans accepted by Vanderbilt Children's Hospital | Excludes Blue Cross Blue Shield Tennessee Medicare Advantage – Blue Advantage. VUMC, MCJCHV, and VWCH are excluded from Network L & E (exchange plans). VBH and VTHH are excluded from Network L. |
| Insurance plans accepted by Vanderbilt My Health Walk-In Clinics | Excludes Blue Cross Blue Shield Tennessee Medicare Advantage – Blue Advantage. VUMC, MCJCHV, and VWCH are excluded from Network L & E (exchange plans). VBH and VTHH are excluded from Network L. Excludes UnitedHealthcare COMPASS (Individual Exchange Plan) (VWCH, VBH, VTHH) and UnitedHealthcare Complete (C-SNP). |
| Insurance plans accepted by Vanderbilt Bedford Hospital | Aetna (Excludes First Health, except Medical Mutual of Ohio) Aetna Behavioral Health Aetna Medicare Advantage Aetna National Advantage Program (fka Coventry National) Aetna Select VHAN (Premier Care Network) Aetna Signature Administrators Aetna TN Preferred Aetna Whole Health Meritain Health Meritain Behavioral Health · Amerigroup Behavioral Health Amerigroup TennCare (Adult services may require prior authorization and be redirected) Amerivantage Medicare Advantage & Dual S. Cigna (Includes PPO, POS, and HMO products under networks LP, OAP and Great West) Cigna Behavioral Health Cigna Connect (Nashville market members only) Cigna SureFit (Adult services require authorization, certain exceptions apply) Cigna-HealthSpring Behavioral Health Cigna-HealthSpring Medicare Advantage (includes MidState IPA members) ... BCBST Preferred Dental BCBST Commercial PPO Dental Cigna Dental PPO Dental Benefit Providers/UHC Dental PPO Dental Health Alliance DentaQuest (TennCare) Guardian Humana Dental PPO Met Life Dental United Concordia · EyeMed Vision Plan – Vanderbilt Eye Institute - Lebanon Providers only ... Cariten Medicare Advantage Cariten HMO, PPO, POS ChoiceCare (includes PPO and National POS. Excludes local POS) Humana (Includes HMO, NPOS and PPO. Excludes local POS) Humana Behavioral Health Humana Medicare Advantage. UnitedHealthcare Group UnitedHealthcare Medicare Complete/AARP UnitedHealthcare – HCA employees (Authorization required) United Healthcare of the River Valley, Inc Heritage Choice and Heritage Select UnitedHealthcare (Excludes Oxford HMO, Pacificare) UnitedHealthcare NEXUS (referrals required on some products) UnitedHealthcare Options PPO UnitedHealthcare – United Medical Resources (UMR) UnitedHealthcare Community Plan (adult services may require authorization and be redirected) UnitedHealthcare Community Plan Dual Special Needs Plan |
| Insurance plans accepted by Vanderbilt Health | If your spouse has access to health coverage through another employer, including Vanderbilt University Medical Center, but prefers using the Vanderbilt Health Plan, you will be charged a $100 monthly fee. This fee will not apply if you both work for Vanderbilt University. The fee will be added to your health care payroll premiums. Medicare coverage does not count as employer-sponsor coverage, so no fee will apply. |
Explore related products
What You'll Learn
Vanderbilt University Medical Center's insurance plans
Vanderbilt University Medical Center and its affiliates are out-of-network participants in several insurance plans. However, several insurance carriers also include Vanderbilt in their individual plans. It is important to note that Vanderbilt may not participate in all products offered by an insurance carrier. Therefore, it is recommended to contact your insurance company to verify your coverage for care delivered at a Vanderbilt facility or physician practice.
Vanderbilt Medical Group is an in-network participant in several local and national health insurance plans. Some of these plans may not apply at every location, depending on the specialty, such as transplant, dental, or vision coverage. Here is a list of some of the insurance plans that Vanderbilt Medical Group participates in:
- Aetna (excluding First Health, except Medical Mutual of Ohio)
- Aetna Behavioral Health
- Aetna Medicare Advantage
- Aetna National Advantage Program (formerly known as Coventry National)
- Aetna Select VHAN (Premier Care Network)
- Aetna Signature Administrators
- Aetna TN Preferred
- Aetna Whole Health
- Meritain Health
- Meritain Behavioral Health
- Amerigroup Behavioral Health
- Amerigroup TennCare (Adult services may require prior authorization)
- Amerivantage Medicare Advantage & Dual S
- Cigna (including PPO, POS, and HMO products under networks LP, OAP, and Great West)
- Cigna Behavioral Health
- Cigna Connect (Nashville market members only)
- Cigna SureFit (Adult services require authorization, with certain exceptions)
- Cigna-HealthSpring Behavioral Health
- Cigna-HealthSpring Medicare Advantage (includes MidState IPA members)
It is important to note that there are specific exclusions for certain facilities within Vanderbilt University Medical Center. For example, VUMC, MCJCHV, and VWCH are excluded from Network L & E (exchange plans), while VBH and VTHH are excluded from Network L. Additionally, Blue Cross Blue Shield Tennessee Medicare Advantage – Blue Advantage is excluded from VUMC, MCJCHV, VWCH, VBH, and VTHH. Similarly, UnitedHealthcare COMPASS (Individual Exchange Plan) and UnitedHealthcare Complete (C-SNP) are excluded from VWCH, VBH, and VTHH.
Vanderbilt University also offers its own health plan, known as the Vanderbilt Group Health Plan, which is available to its employees and their dependents. This plan is subject to certain conditions, such as a spousal coverage fee, which encourages spouses to take coverage offered by their employers if available. Additionally, Vanderbilt follows the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which allows qualified Vanderbilt Group Health Plan members to enroll if they become eligible for state-granted premium assistance or lose their coverage under specific circumstances.
Claiming Medical Insurance Relief in Ireland: A Guide
You may want to see also
Explore related products
Insurance carriers that include Vanderbilt in their individual plans
Vanderbilt University Medical Center and its affiliates are out-of-network participants in several insurance plans. However, several insurance carriers include Vanderbilt in their individual plans. It is important to note that Vanderbilt may not participate in all products offered by an insurance carrier.
- Aetna (Excluding First Health, except Medical Mutual of Ohio): This includes Aetna Behavioral Health, Aetna Medicare Advantage, Aetna National Advantage Program (formerly known as Coventry National), Aetna Select VHAN (Premier Care Network), Aetna Signature Administrators, Aetna TN Preferred, and Aetna Whole Health.
- Meritain Health: This includes Meritain Behavioral Health.
- Amerigroup: Amerigroup Behavioral Health and Amerigroup TennCare (adult services may require prior authorization).
- Cigna: This includes Cigna PPO, POS, and HMO products under networks LP, OAP, and Great West. It also covers Cigna Behavioral Health, Cigna Connect (for Nashville market members only), Cigna SureFit (with certain exceptions for adult services), and Cigna-HealthSpring Medicare Advantage (including MidState IPA members).
- UnitedHealthcare: This includes UnitedHealthcare Group, UnitedHealthcare Medicare Complete/AARP, UnitedHealthcare – HCA employees (authorization required), UnitedHealthcare Options PPO, and UnitedHealthcare Community Plan (with certain conditions for adult services).
It is always advisable to contact your insurance company directly to verify your coverage for care delivered at a Vanderbilt facility or physician practice.
Understanding Insurance Coverage for Your Son's Health
You may want to see also
Explore related products
$8
Insurance plans for Vanderbilt Bedford Hospital
Vanderbilt University Medical Center and its affiliates are out-of-network participants in several insurance plans. However, several insurance carriers also include Vanderbilt in their individual plans. It is important to note that Vanderbilt may not participate in all products offered by an insurance carrier.
Vanderbilt Bedford Hospital, as a part of Vanderbilt Medical Group, is an in-network participant in several local and national health insurance plans. Here is a list of insurance plans accepted by Vanderbilt Bedford Hospital:
Aetna Insurance Plans:
- Aetna (Excludes First Health, except Medical Mutual of Ohio)
- Aetna Behavioral Health
- Aetna Medicare Advantage
- Aetna National Advantage Program (formerly known as Coventry National)
- Aetna Select VHAN (Premier Care Network)
- Aetna Signature Administrators
- Aetna TN Preferred
- Aetna Whole Health
Meritain Insurance Plans:
- Meritain Health
- Meritain Behavioral Health
Amerigroup Insurance Plans:
- Amerigroup Behavioral Health
- Amerigroup TennCare (Adult services may require prior authorization and redirection)
- Amerivantage Medicare Advantage & Dual S
Cigna Insurance Plans:
- Cigna (Includes PPO, POS, and HMO products under networks LP, OAP, and Great West)
- Cigna Behavioral Health
- Cigna Connect (Nashville market members only)
- Cigna SureFit (Adult services require authorization, certain exceptions apply – please verify with the health plan)
- Cigna-HealthSpring Behavioral Health
- Cigna-HealthSpring Medicare Advantage (includes MidState IPA members)
UnitedHealthcare Insurance Plans:
- UnitedHealthcare Group
- UnitedHealthcare Medicare Complete/AARP
- UnitedHealthcare – HCA employees (Authorization required)
- United Healthcare of the River Valley, Inc
- Heritage Choice and Heritage Select UnitedHealthcare (Excludes Oxford HMO, Pacificare)
- UnitedHealthcare NEXUS (referrals required on some products)
- UnitedHealthcare Options PPO
- UnitedHealthcare – United Medical Resources (UMR)
- UnitedHealthcare Community Plan (adult services may require authorization and redirection)
- UnitedHealthcare Community Plan Dual Special Needs Plan
It is always recommended to contact your insurance company to verify your coverage for care delivered at a Vanderbilt facility or by a Vanderbilt clinician. Additionally, specific Vanderbilt entities, such as the Vanderbilt Eye Institute, may have their own accepted insurance plans.
Gum Restoration: Medical or Dental Insurance Coverage?
You may want to see also
Explore related products
Vanderbilt Health Plan spousal coverage
Vanderbilt University Medical Center and its affiliates are out-of-network participants in several insurance plans. However, several insurance carriers also include Vanderbilt in their individual plans. It is important to note that Vanderbilt may not participate in all products offered by an insurance carrier.
Medicare coverage does not count as employer-sponsored coverage, so no fee will apply if your spouse has Medicare. Vanderbilt has implemented a spousal coverage fee to encourage spouses to take the coverage offered by their employers. However, Vanderbilt recognizes that there may be circumstances where the Vanderbilt University plan is more attractive, such as family convenience, providers, or cost. In such cases, the $100 per month fee would still apply.
Spousal coverage fees are standard in employer-sponsored plans, and a $100 monthly surcharge is the most common fee. This surcharge keeps Vanderbilt University aligned with similar-sized organizations.
Vanderbilt University partners with Aetna to offer health coverage to full-time and part-time employees. Health plan option eligibility varies based on employment status. For fully benefits-eligible employees, Aetna automatically issues health insurance cards for the Choice CDHP health plan option at the employee-only coverage tier.
Health care premiums are determined by your Annual Base Benefits Rate (ABBR), which is usually your annual salary. Premiums are typically noted as monthly amounts, but if you are paid weekly or biweekly, these amounts are divided evenly between paychecks each month. Vanderbilt offers a $20 monthly credit to your health care premiums if you and your covered family members are committed to being tobacco-free.
Medical Insurance Companies in Washington: A Comprehensive Overview
You may want to see also
Explore related products
Vanderbilt Group Health Plan
The Vanderbilt Group Health Plan is available to full-time and part-time employees, with health plan option eligibility varying based on employment status. The plan is provided in partnership with Aetna, which automatically issues health insurance cards for the Choice CDHP health plan option at the employee-only coverage tier.
The Vanderbilt Group Health Plan offers 100% coverage for preventive care and screenings, with no deductible or co-pay required, as long as the service meets the guidelines for a preventive care service and is not for diagnosis screenings. The plan also offers a choice of in-network and out-of-network providers.
Health care premiums for the Vanderbilt Group Health Plan are determined by the Annual Base Benefits Rate (ABBR), which is usually equal to an individual's annual salary. Premiums are broken up into three bands: Band A ($0-$59,999.99), Band B ($60,000.00 - $149,999.99), and Band C ($150,000.00+). Vanderbilt offers a $20 monthly credit towards health care premiums if the employee and their covered family members are committed to being tobacco-free.
The Vanderbilt Group Health Plan also includes optional vision coverage and dental coverage for certain packages, particularly for international and graduate students. Additionally, the Student Health Insurance Plan (SHIP) is available for students, with annual coverage effective from August 12, 2024, through August 11, 2025. SHIP provides students with access to the Student Health Center (SHC), which serves as the primary care provider.
Criminal History: Can Medical Insurers Drop Policyholders?
You may want to see also
Frequently asked questions
Vanderbilt University Medical Center is an out-of-network participant in several insurance plans. However, some insurance carriers include Vanderbilt in their individual plans. Accepted insurance plans vary across facilities, so it is recommended to contact your insurance company to verify your coverage.
Monroe Carell Jr. Children's Hospital at Vanderbilt does not accept Blue Cross Blue Shield Tennessee Medicare Advantage – Blue Advantage. It also excludes UnitedHealthcare COMPASS (Individual Exchange Plan) and UnitedHealthcare Complete (C-SNP).
Vanderbilt Bedford Hospital accepts insurance plans such as Cigna, Cigna Behavioral Health, Cigna Connect, Cigna SureFit, Cigna-HealthSpring Behavioral Health, and Cigna-HealthSpring Medicare Advantage. It also accepts plans like Aetna, Aetna Behavioral Health, Aetna Medicare Advantage, and Aetna National Advantage Program.
Yes, Vanderbilt University offers a health plan for its employees. If an employee's spouse has access to health coverage through another employer but prefers the Vanderbilt Health Plan, a $100 monthly fee will be charged.
Vanderbilt Group Health Plan is offered to qualified members under the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This allows special enrollment rights if you or your dependent become eligible for state-granted premium assistance or lose coverage under specific programs like Medicaid.
