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Health Insurance Information

Cincinnati Children's strives to accept a wide variety of health plans. The only way to determine your child's individual coverage is by contacting your insurance carrier directly. Refer to your insurance card for a contact phone number.

Note: Do not consider this list a binding agreement or guarantee of coverage.

Contact your health insurance carrier to verify coverage for your specific benefit plan.

Most common commercial plans

  • Aetna
  • Anthem Blue Cross & Blue Shield
  • Cigna
  • Medical Mutual of Ohio
  • Humana Insurance Company
  • United HealthCare of Ohio, Inc.

Other commercial plans:

  • Beech Street Corporation
  • Evolutions Healthcare Systems, Inc.
  • First Health Group / Coventry Health Care
  • Galaxy Health Network
  • HealthLink, Inc.
  • Health Ohio Network - Elite Product
  • Health Ohio Network
  • HealthSmart Preferred Care
  • MedBen
  • Ohio Health Choice
  • Paramount Health Care (Letter of Agreement only, not advertised as a participating provider)
  • Private Healthcare Systems, Inc.

What if I don’t see my plan listed?

If you don’t see your plan listed, you may need to obtain permission for your child to be treated at Cincinnati Children’s in order to ensure you and your family do not incur any unexpected out-of-pocket expenses. We recommend you do the following:

  1. Check with your child’s primary care physician (PCP) to obtain a referral to Cincinnati Children’s;
  2. Check with Member Services or your care manager with your insurance plan to seek an exception and authorization for your child to be treated at Cincinnati Children’s; and
  3. You may also need to contact your employer’s HR department.

Each state approved specific companies to sell plans on the exchanges. Many hospitals, including Cincinnati Children's, do not contract with all of the plans in their state's exchange.

Learn more about the Health Care Exchange plans contracted by Cincinnati Children’s.

Contact your health insurance carrier to verify coverage for your specific benefit plan:

Ohio

  • Ohio Medicaid
  • Aetna Better Health OhioRISE
  • AmeriHealth Caritas Ohio
  • Anthem
  • Buckeye Community Health Plan
  • CareSource
  • Humana Healthy Horizons
  • Molina Healthcare of Ohio, Inc.
  • UnitedHealthcare Community Plan

Kentucky

  • Kentucky Medicaid
  • Anthem
  • Aetna Better Health of Kentucky
  • Humana Healthy Horizons
  • Passport Health Plan by Molina Healthcare
  • UnitedHealthcare Community Plan
  • WellCare of Kentucky

Indiana

  • Indiana Medicaid
  • Anthem
  • CareSource
  • MDWise Excel Network
  • Managed Health Services (MHS)

West Virginia

  • WV Medicaid
  • The Health Plan (Letter of Agreement only, not advertised as a participating provider)

What if I don’t see my plan listed?

If you don’t see your plan listed, you may need to obtain permission for your child to be treated at Cincinnati Children’s in order to ensure you and your family do not incur any unexpected out-of-pocket expenses. We recommend you do the following:

  1. Check with your child’s primary care physician (PCP) to obtain a referral to Cincinnati Children’s; and
  2. Check with Member Services or your care manager with your Medicaid plan to seek an exception and authorization for your child to be treated at Cincinnati Children’s.

Please Note: Behavior Health Plans may be managed by a different insurance provider than your health insurance. Please check your health insurance card for a separate plan that manages your behavioral health benefit.

  • Cenpatico (Buckeye Health Plan members only)
  • Cigna Behavioral Health (Cigna behavioral health carrier)
  • Humana Behavioral Health
  • Optum Behavioral Health (formerly United Behavioral Health, Inc.)(United Healthcare behavioral Health carrier)

What if I don’t see my plan listed?

If you don’t see your plan listed, you may need to obtain permission for your child to be treated at Cincinnati Children’s in order to ensure you and your family do not incur any unexpected out-of-pocket expenses. We recommend you do the following:

  1. Check with your child’s referring provider and/or primary care physician (PCP) to obtain a referral to Cincinnati Children’s;
  2. Check with Member Services or your care manager with your insurance plan to seek an exception and authorization for your child to be treated at Cincinnati Children’s; and
  3. You may also need to contact your employer’s HR department.

 

Cincinnati Children’s does not have a contract with the following plans/payors:

  • Imagine360
  • Oscar Health Insurance
  • Custom Design Benefits is contracted, except for the following employers (not contracted):
    • Talbert House
    • The Children’s Home
    • Byer Steel
    • Ashley Ward
    • Rotary Forms
    • Jack Sweeny

All Medicare Advantage Plans (Anthem, Humana, UHC, etc)

Marketplace Plans including:

  • Ambetter Buckeye Marketplace Plan
  • Anthem Pathway HMO/Anthem Pathway HMO X
  • CareSource Marketplace Plan (Indiana only)
    Please Note: We do accept CareSource Marketplace plans in Ohio and Kentucky.
  • Molina of Ohio Marketplace Plan
  • United Compass
  • QHP- Qualified Health Plan (Aetna Marketplace Exchange)

Other plans including:

  • Indiana HIP plans (managed by Anthem, MHS, MDWise)

MyCare Ohio Plans:

  • Molina
  • Aetna Better Health
  • Buckeye
  • CareSource
  • United Healthcare Connected

Cincinnati Children’s has contracted with the majority of networks that provide Specialty/Transplant care. Contact your plan manager to verify coverage for your specific benefit plan:

  • Aetna
  • Anthem
  • Blue Cross/Blue Shield Association (BDCT)
  • Cigna LifeSource
  • Coventry Health Care, Inc.
  • Humana
  • INTERLINK Health Services, Inc.
  • LifeTrac/Emerging Therapy Solutions
  • MultiPlan, Inc.
  • Optum (formerly United Resource Networks)
  • 6 Degrees

What if I don’t see my plan listed?

If you don’t see your plan listed, you may need to obtain permission for your child to be treated at Cincinnati Children’s in order to ensure you and your family do not incur any unexpected out-of-pocket expenses. We recommend you do the following:

  1. Check with Member Services or your care manager with your insurance plan to seek an exception and authorization for your child to be treated at Cincinnati Children’s; and
  2. You may also need to contact your employer’s HR department.

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