Paul Sanchez
Cleveland Clinic, a world-renowned medical institution, accepts a wide range of insurance plans, including Medicare, Medicaid, and Marketplace health insurance plans. They have agreements with major insurance providers such as UnitedHealthcare, which covers plans like Preferred Care Partners and Preferred Care Network. Additionally, they accept plans from other providers like Aetna, Anthem, Cigna, Humana, and Medical Mutual. Cleveland Clinic also caters to international patients with specialized services, but it is important for them to check their international policies for accepted networks.
| Characteristics | Values |
|---|---|
| Marketplace health insurance plans | Accepted via Healthcare.gov |
| Medicare | Accepted |
| Medicaid | Accepted |
| UnitedHealthcare | Accepted in Florida |
| PPO network | Accepted |
| International health insurance plans | Accepted if in one of the above-mentioned networks |
| HMO health insurance plan | May require a referral from a PCP to see a specialist |
| Insurance providers | Aetna, Anthem, Cigna, Humana, Medical Mutual, and more |
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What You'll Learn
UnitedHealthcare and Cleveland Clinic
Cleveland Clinic, a world-renowned medical institution, accepts UnitedHealthcare insurance. However, if you have UnitedHealthcare insurance through your employer or a Medicare Advantage, MyCare, or Community (Medicaid) Plan, your financial responsibility when seeking care at the Cleveland Clinic may increase. This is because the majority of Cleveland Clinic locations across Ohio, Florida, and Nevada will be out of network.
If you have United Behavioral Health or Optum Behavioral Health coverage for behavioural health services, your financial responsibility when seeking care at the Cleveland Clinic may increase if an agreement cannot be reached.
If you have UnitedHealthcare as a secondary insurance, Medicare supplemental plans are not impacted by these negotiations. You can continue scheduling appointments as normal.
The Cleveland Clinic also accepts a variety of plans from other insurance companies at all of its locations. An inclusive list of accepted health insurance plans can be found on the Cleveland Clinic website. These include Marketplace health insurance, Medicare, and Medicaid.
The Cleveland Clinic has also joined SummaCare's Medicare Advantage network, meaning that SummaCare Medicare members will have access to approximately 6,000 Cleveland Clinic physicians and providers across all of its northeast Ohio locations.
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Medicare Advantage plans
As a multi-specialty academic medical centre, the Cleveland Clinic offers a wide range of medical services, including cardiology, oncology, neurology, orthopaedics, gastroenterology, paediatrics, and urology. The Cleveland Clinic accepts various health insurance plans, including Medicare Advantage plans, which are offered by specific providers.
The Cleveland Clinic has partnered with SummaCare, a provider-owned regional health insurance company based in Akron, Ohio, to offer Medicare Advantage plans. This partnership, which began in August 2021, allows SummaCare Medicare members to access Cleveland Clinic's extensive network of physicians and providers across northeast Ohio locations, including Cleveland Clinic Akron General. SummaCare's Medicare Advantage network now includes over 22,000 providers and more than 75 hospitals across 31 counties in Ohio, providing a comprehensive range of healthcare services to its members.
SummaCare has earned recognition for its quality and excellence in healthcare. In 2021, it received a 4-Star Quality Rating from the Centers for Medicare and Medicaid Services, acknowledging its performance in crucial areas such as customer service, wellness, disease management, and responsiveness. Additionally, SummaCare boasts a high member renewal rate, with 96% of members choosing to renew their coverage each year.
If you are considering enrolling in a Medicare Advantage plan, it is essential to review the specific details of the plan offered by SummaCare. The annual enrollment period for Medicare coverage typically occurs in the last quarter of the year, allowing individuals to make informed decisions about their healthcare options for the following year.
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Medicaid
Cleveland Clinic is a world-renowned medical institution that offers a wide range of medical services, including cardiology, oncology, neurology, orthopedics, and more. The clinic is committed to patient-centric care and accepts various insurance plans to ensure that patients can access the care they need.
When it comes to Medicaid, Cleveland Clinic accepts this type of insurance at its locations in Ohio. As of 2024, the accepted Medicaid plans in Ohio include AmeriHealth Caritas of Ohio and Anthem Medicaid. It is important to note that insurance plans and coverage may change over time, so it is always a good idea to contact Cleveland Clinic or your insurance provider directly to confirm that your specific Medicaid plan is accepted at their facilities.
Cleveland Clinic also participates in many government plans, including Medicare and TriCare. They accept a wide variety of insurance and managed care plans at their main campus in Weston, Florida, as well as their community hospitals and family health centers in the region. Starting January 1, 2025, Cleveland Clinic facilities and providers in Florida will no longer be in-network for AvMed Medicare Advantage members. However, they work with many leading insurance providers, and patients can call to learn more about their insurance partners.
If you have a health insurance plan with a PPO network, you can go to Cleveland Clinic but may be billed out-of-network fees. It is important to understand your insurance coverage and potential costs before seeking treatment. Cleveland Clinic offers resources to help patients understand how insurance plans and healthcare benefits affect care access and costs. They also provide a cost estimator on their website to help patients determine their out-of-pocket expenses.
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International health insurance plans
Cleveland Clinic, a world-renowned medical institution, accepts a variety of health insurance plans, including some international health insurance plans. The specific plans that are accepted can vary by location and are subject to change, so it is important to verify with Cleveland Clinic and your insurance provider to confirm coverage.
For Cleveland Clinic Florida, the following insurance plans are accepted:
- Accountable Health Plans of America, Inc. – Indian River only
- Cigna Healthcare of Florida Inc.
- MultiPlan – Excludes Practitioner/Ancillary Only plans and may have Limited Benefit plan exclusions
- Neighborhood Health Partnership – Regional, Part of UHC
- Health insurance contracted directly with Cleveland Clinic by employers
For the Cleveland Clinic main campus, the following insurance plans are accepted:
- Anthem Blue Cross Blue Shield Pathway HMO – Akron General, Wooster Ambulatory Surgery Associates, and Mercy Hospital only
- Ambetter from Buckeye Health Plan - Mercy Hospital only
- CareSource Marketplace – Akron General, Union Hospital, and Mercy Hospital only
- Molina Healthcare Marketplace – Mercy Hospital only
- North American Health Plan, Inc.
- North Shore-LIJ Health Plan
- Tertiary Care Network
Some international health insurance plans are accepted at Cleveland Clinic if they participate in one of the network plans. Global Medical Management Inc. (GMMI) is listed as an accepted insurance company for individuals and families living outside their home country. It is important to check with your specific international health insurance plan to confirm that Cleveland Clinic is included in their network.
In addition to the accepted insurance plans listed above, Cleveland Clinic also accepts Medicare and Medicaid plans, including:
- Buckeye Wellcare by Allwell Dual Access (HMO D-SNP) – Does not include Buckeye AllWell Medicare HMO
- United Healthcare Community Plan of Ohio Medicaid
To verify coverage and understand your potential out-of-pocket expenses, it is recommended to contact both Cleveland Clinic and your insurance provider. Cleveland Clinic provides resources to assist international patients with travel arrangements, language interpretation, and other necessary support.
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Health insurance plans with PPO networks
The Cleveland Clinic, a world-renowned medical institution, accepts a wide range of health insurance plans, including some with PPO networks. PPO stands for Preferred Provider Organization, which is a type of health insurance plan that offers its members a large network of preferred providers, including doctors, specialists, and hospitals, with negotiated rates.
PPO plans provide flexibility in choosing healthcare providers. With a PPO plan, you can see any doctor, but you will save money by using in-network providers, as these providers offer care at the lowest out-of-pocket cost. You can still see out-of-network providers with a PPO plan, but it will typically come with higher costs and more complex billing. Out-of-network visits may result in unexpected charges, making it challenging to budget for medical expenses. Additionally, PPO plans generally have higher monthly premiums, deductibles, copayments, and coinsurance compared to other types of plans.
The benefits of a PPO plan include the freedom to choose any healthcare provider without needing referrals, making it convenient for those who travel frequently or have complex medical conditions that require specialized care. PPO plans are also suitable for those who prioritize having a wide range of provider options and want streamlined access to specialists.
When considering a PPO plan, it is essential to understand the trade-offs between flexibility and cost. While PPO plans offer convenience and freedom, the higher premiums and out-of-pocket expenses associated with out-of-network care can add up quickly. Therefore, it is advisable to check if your preferred doctors are part of the PPO network to maximize the cost-saving benefits of the plan.
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Frequently asked questions
The Cleveland Clinic accepts a wide range of insurance plans, including Marketplace health insurance, Medicare, and Medicaid. They also accept some exchange health plans and international health insurance plans.
Yes, the Cleveland Clinic has agreements with UnitedHealthcare, Aetna, and Blue Cross Blue Shield (BCBS).
If you have a PPO plan that allows you to see providers outside your network, you can go to the Cleveland Clinic but may be billed out-of-network fees.
Yes, the Cleveland Clinic offers an Employee Health Plan (EHP) that includes access to Cleveland Clinic-employed physicians and facilities, as well as other local contracted providers.
