Frequently Asked Questions

• Please bring a photo ID, if you have insurance, the most up-to-date insurance card, and a method of payment. *

• If you are not the policy holder, please bring their address, contact number and social security number.

• If you have been injured on the job, bring any internal forms required by your employer, the name and address of the BWC insurance carrier, and policy numbers.

• Aetna
• Anthem
• Cigna
• Cofinity (an Aetna subsidiary)
• Coventry (an Aetna subsidiary)
• First Health (an Aetna subsidiary)
• FrontPath Health Coalition
• The Health Plan
  • Formerly The Health Plan of Upper Valley
• Healthlink
• HealthSmart
  • Formerly Emerald Health Plan
  • Formerly Interplan Health Group
• Humana*
  *The following two Humana plans we are not contracted with:
  • Humana Dayton HMOx/Select RX Network
  • Humana Cincinnati/Northern KY HMOx
• Medical Mutual of Ohio
• Multiplan
• Ohio Health Choice
• HealthReach Preferred (an Ohio Health Group, ER and referral authorization only)
  • AKA Healthy Associates and/or Ohio Healthy
• LifeTrac
• Ohio PPO Connect
• OSU Health Plan
• OSU Student Health Plan
• Paramount
• PHCS
• Quality Care Partners (QCP)
• UnitedHealthcare
• United Resource Network Oncology (an Optum subsidiary)

• Breast and Cervical Cancer Project (BCCP)
• Veteran’s Affairs Community Care Network Optum (VA CCN Optum)
• Ohio Department of Rehabilitation and Correction (ODRC, Prison)
• Ryan White Program
  • Laboratory and professional only
• TriCare – Humana Military

• Buckeye Ambetter     
• CareSource Marketplace
• Molina Healthcare of Ohio

Open Enrollment – Non-Medicare patients

Open enrollment occurs annually from November 1-January 15. During this window, those who are not Medicare eligible can purchase a health insurance plan through the Marketplace. For more information, visit https://www.healthcare.gov.

• AmeriHealth Caritas
• Buckeye Community Health Plan
• CareSource
• Humana Healthy Horizons
• Medicaid Ohio Traditional
• Molina Healthcare of Ohio
• UnitedHealthcare Community Plan

Medicare Advantage January 1, 2025

All Anthem Medicare Advantage plans will be Out -of – Network.

• Aetna Medicare (HMO)
• Aetna Medicare Premier 1 (PPO)
• Aetna Medicare Premier 2 (PPO)
• Aetna Medicare Premier Plus 1 (PPO)
• Aetna Medicare Premier Plus 2 (PPO)
• Aetna Medicare SmartFit (PPO)
• Aetna Medicare Value Plan (PPO)
• Anthem Chronic Special Needs (CSNP)
• Anthem MediBlue Access (PPO)
• Anthem MediBlue Access Basic (Regional PPO)
• Anthem MediBlue Access Core (Regional PPO)
• Anthem MediBlue Dual Advantage (HMO D-SNP)
• Anthem MediBlue Extra (HMO)
• Anthem MediBlue Preferred (HMO)
• Anthem MediBlue Preferred Plus (HMO)
• Anthem MediBlue Service (PPO)
• Buckeye – Wellcare No Premium Open (PPO)
• Buckeye – Wellcare No Premium (HMO)
• Buckeye – Wellcare Assist (HMO)
• Buckeye – Wellcare Giveback (HMO)
• Buckeye – Wellcare Dual Access Open (PPO D-SNP)
• Buckeye – Wellcare Dual Access (HMO D-SNP)
• Buckeye – Wellcare All Dual Assure (HMO D-SNP)
• CareSource Medicare Advantage Ohio D-SNP (HMO)
• HumanaChoice (PPO)
• HumanaChoice SNP-DE (PPO DSNP)
• HumanaChoice (Regional PPO)
• Humana Gold Choice (PFFS)
• Humana Gold Plus (HMO-POS)
• Humana Gold Plus (HMO)
• Humana Gold Plus – Diabetes and Heart (HMO C-SNP)
• Humana Gold Plus SNP-DE (HMO DSNP)
• Humana Together in Health (PPO ISNP)
• Humana USAA Honor (PPO)
• Humana USAA Honor with Rx (PPO)
• Humana Value Plus (PPO)
• The Health Plan SecureCare (HMO)
• The Health Plan SecureCare SNP (HMO D-SNP)
• The Health Plan SecureChoice (PPO)
• Mount Carmel MediGold Cash Back No Premium (HMO)
• Mount Carmel MediGold Cash Back No Premium MA Only (HMO)
• Mount Carmel MediGold Choice (PPO)
• Mount Carmel MediGold No Premium (HMO)
• Mount Carmel MediGold No Premium Choice (PPO)
• Mount Carmel MediGold Plus (HMO)
• Mount Carmel MediGold Premier (HMO)
• Mount Carmel MediGold Trinity EGWP (HMO)
• MedMutual Advantage Access PPO
• MedMutual Advantage Classic HMO
• MedMutual Advantage Secure HMO
• MedMutual Advantage Select PPO
• MedMutual Advantage Signature HMO
• Molina Dual Options MyCare Ohio (Medicare-Medicaid Plan)
• Molina Medicare Choice Care (HMO)
• Molina Medicare Choice Care Select (HMO)
• Molina Medicare Complete Care (HMO D-SNP)
• Molina Medicare Complete Care Select (HMO D-SNP)
• Perennial Advantage Freedom (HMOPOS)
• Perennial Advantage Premier (HMOPOS I-SNP)
• Perennial Advantage Strive (HMO I-SNP)

All traditional Medicare plans and Medicare plans with Medigap coverage are also accepted at the OSUCCC – James and at the Ohio State Wexner Medical Center. Plans that include Ohio State are subject to change.

Open enrollment occurs from Oct. 15-Dec. 7 each year. During this window, you can join, switch or drop a plan. Your coverage will begin on Jan. 1 (as long as the plan gets your request by Dec. 7).

OSHIIP

The Ohio Senior Health Insurance Information Program (OSHIIP) is a free resource available to provide Medicare beneficiaries with free, objective health insurance information, one-on-one counseling and education about Medicare, Medicare prescription drug coverage (Part D), Medicare Advantage options and Medicare supplement insurance. To learn more, contact OSHIIP directly at OSHIIP Hotline: 800-686-1578 or by email at OSHIIPmail@insurance.ohio.gov.

This list is not inclusive of all non-accepted plans at Madison Health.

• 6 Degrees Health
• Aetna Exchange
• Aetna Trinity
• Anthem Medicaid
• Anthem Marketplace Exchange
• Aultcare
• Humana Dayton HMOx/Select RX Network
• Humana Cincinnati/Northern KY HMOx
• Medical Mutual Marketplace Exchange
• MMO MedFlex HMO
• Oscar
• Referenced Based Pricing Plans/Health Share Plans
• Sidecar Health
• UnitedHealthcare HMO Medicare Advantage
• UnitedHealthcare Marketplace Exchange