CONTRACT NAME INSURANCE CARD TYPICAL NAME PRODUCT TYPE UCMC TDC WCH UCPC PSYC IN 3-Hab 3-hab Ohio Worker's Comp ID Card Worker's Comp YES YES YES YES AARP Medicare Advantage AARP Medicare Complete (underwritten by United Health Care) In network 1-1-16 Medicare Advantage YES YES YES YES YES AARP Supplemental Only AARP (Supplemental underwritten by United Healthcare) Commercial YES YES YES YES YES Aetna Better Health Medicaid Dual - Ohio My Care Ohio (Aetna logo) Aetna Better Health of Ohio There is no Medicare logo if it is only Medicaid portion of a dual Dual Medicaid portion YES YES YES YES YES Aetna Better Health Medicare Dual-Ohio My Care Ohio (Aetna logo) Aetna Better Health of Ohio (Medicare logo on card) Dual Medicare portion YES YES YES YES YES Aetna Cincinnati Preferred Aetna Cincinnati Preferred All YES YES YES YES YES YES Aetna KY Better Health formerly Coventry Cares Aetna Better Health of Kentucky KY Managed Medicaid YES YES YES YES Aetna KY Exchange Aetna (QHP) is the identifier for Exchange Exchange Aetna Medicare Aetna Medicare SERS Aetna Medicare OPERS Aetna Medicare STRS PPO Aetna Medicare PFFS (no contract so physician choice to treat) Medicare YES YES YES YES YES Aetna Transplant-Back in Network eff 12-1-13 Aetna - Transplant must call Transplant YES YES YES Transplant Only Aetna Open Access Aetna U.S. Healthcare-Became Participating again Aetna 8-1-12Select All YES YES YES YES YES Aetna Whole Health (Exchange) Aetna Whole Health Ohio Health Exchange Alliance Behavioral Care Alliance Behavioral Care on back of cards Behavioral Amerigroup Amerigroup Amerigroup Community Care Amerigroup Real Solutions OH Managed Medicaid Anthem Anthem BC/BS Blue Cross Blue Shield Blue Traditional BC/BS Federal Employee Program BC/BS University of Cincinnati Employees begin 1-01-15 Commercial YES YES YES YES YES Anthem BCBS Blue Priority Anthem Blue Priority Blue Priority HMO Transplant only YES Anthem Liver Transplant BDCT Anthem Liver Transplant must call Transplant YES Transplant Only YES Anthem Managed Medicaid (Indiana) Anthem Medicaid with YRH or YRK prefix on member ID Managed Medicaid Anthem Managed Medicaid (Kentucky) Anthem Medicare Select Anthem Medicaid with XTF prefix on member ID Out Of Network even for Primary Care PHysicians as of 8/1/15 Managed Medicaid Anthem Medicare Preferred Select (PPO) Anthem Medicare Preferred Standard (PPO) Anthem Senior Advantage Plus (HMO) Anthem Dual Advantage (HMO SNP) Blue Medicare Access Value (RPPO) 7-1-15 WCH, UCPC and TDC In Network Medicare Select PPO or HMO YES YES YES please check with your physician. 1 2/5/2016
Anthem Pathway X - OHIO Anthem Gold Pathway Anthem Silver, Bronze or Platinum Member ID begins with JWQ OH Health Exchange YES YES YES YES YES Anthem Pathway X -KENTUCKY Anthem Gold Pathway Anthem Platinum, Silver or Bronze Suitcase logo is PPO or PPOB In Network 1.1.2016 KY Exchange YES YES YES YES YES Beech Street (InterCorp - Gates McDonald) Beech Street may be found on multiple different cards All YES YES YES YES Bluegrass Family Health Bluegrass Family Health KY Exchange Buckeye Advantage Medicare Advantage by Buckeye Community Health Plan; member will have traditional OH Medicaid as secondary; not part of MyCare OH Managed Medicare YES YES YES YES YES Buckeye AmBetter Exchange AmBetter Buckeye Cenpatico for Behavioral Health OH Health Exchange YES YES YES YES Buckeye Cenpatico Behavioral Plan Buckeye Ambetter Behavioral Health * UC Health does T have a contract but if Authorization is obtained it is accepted Behavioral * * * * * Buckeye Dual Medicaid Only Buckeye MyCare Ohio - Medicaid (back of card says Medicaid Member Only) There is no Medicare logo when it is Medicaid only Dual Medicaid portion YES YES YES YES YES Buckeye Dual Medicare Buckeye MyCare Ohio Medicare logo on front of card Dual Medicare portion YES YES YES YES YES Buckeye Medicaid Buckeye Community Health Plan (not part of a dual enrollment) typically CFC and ABD OH Managed Medicaid YES YES YES YES YES CareSource CareSource OH Managed Medicaid YES YES YES YES YES CareSource Advantage CareSource Managed Medicare SNP OH Medicare and SNP YES CareSource-Just 4 Me IN Just 4 Me IN CareSource IN Health Exchange CareSource-Just 4 Me KY Just 4 Me KY CareSource KY Exchange CareSource-Just 4 Me OH Just 4 Me CareSource In Network as of 2.1.15, Ohio Only OH Health Exchange YES YES YES YES YES Center Care Center Care All YES YES YES YES YES CHA HMO-Part of Humana Choice Care Humana All YES YES YES YES YES Champus Tricare Healthnet United States Uniformed Services Tricare Healthnet Prime or Standard Tricare Champus Local VA patients will not have a card. You must have a paper referral to be scanned. All YES YES YES YES YES CIGNA All CIGNA commercial, except Behavioral All YES YES YES YES CIGNA Lifesource CIGNA Lifesource Transplant must call Transplant YES Transplant Only Concert Health Plan Concert Health Plan All YES YES YES YES YES Crossroads Hospice Crossroads Hospice Hospice YES YES YES Custom Design Benefits Network True Cost *see separate plan for Maple Knoll, HealthSpan and Medical Mutual of Ohio Commercial Destiny Hospice (formerly Odyssey Healthcare of Cincinnati) Destiny Hospice Hospice YES YES YES please check with your physician. 2 2/5/2016
DCA or Direct Care America Chandler Group Interplan Ohio Com Network Direct Care America (DCA) All YES YES YES YES YES Emerald Health Network HealthSmart logo Emerald Health Network logo Indiana State Council of Roofers Health and Welfare All YES YES YES YES YES Evercare Hospice Evercare Hospice Hospice YES YES YES YES First Health Network (Affordable, CCN, PHS) First Health logo on the back of different cards All YES YES YES First Health Network (Affordable, CCN, PHS) First Health logo on the back of different cards; worker's comp noted hopefully Worker's Comp YES YES YES Florence Freedom (no payor relations contract) No card - UC Health has a unique contract Other Non Govt YES YES YES Gateway Health Medicare Assured Select Gateway Health Medicare Assured Select Managed Medicare Great West (One Health Plan) Great West CIGNA One Health All YES YES YES YES HealthSpan HealthSpan PPO HealthSpan Preferred HealthSpan Butler Health Plan HealthSpan All YES YES YES YES YES HealthSpan Medicare Advantage HealthSpan Medicare Advantage OH Managed Medicare HealthSpan Select HealthSpan-Select Select is the key word for the Exchange plan OH Health Exchange Heart and Hands Hospice Heart and Hands Hospice Hospice YES YES YES YES YES Heartland Hospice Heartland Hospice Hospice YES YES YES Hoosier MDwise MDWISE Hoosier IN Managed Medicaid YES YES YES PBP Hoosier MDwise Marketplace MDwise Marketplace IN Health Exchange Hospice of Bluegrass Hospice of Bluegrass Hospice YES Hospice of Cincinnati Hospice of Cincinnati Hospice YES YES YES Hospice of Dayton Hospice of Dayton Hospice YES YES YES Hospice of Hope Hospice of Hope Hospice YES YES YES Hospice of Middletown Hospice of Middletown Hospice YES YES YES Hospice of Southwest Ohio Hospice of Southwest Ohio Hospice YES YES YES Humana Humana All Other Commercial YES YES YES YES YES Humana ChoiceCare ChoiceCare Humana All YES YES Humana HMOx Humana HMOx OH Health Exchange Transplant Only Humana Medicare HMO Humana Gold Plus HMO OH Managed Medicare Humana Medicare PFFS Humana Gold Choice PFFS Medicare logo Medicare YES YES YES YES YES Humana Medicare PPO Humana PPO Medicare logo Medicare YES YES YES YES YES Humana National Transplant Humana National Transplant- Transplant must call Transplant Transplant only Transplant Only Humana Preferred Humana Preferred POS or PPO Commercial Humana TriHealth Humana TriHealth Commercial Humana/Caresource CareSource Humana KY Managed Medicaid please check with your physician. 3 2/5/2016
InHealth Ohio PPO Connect in health Ohio PPO Connect Begins 1-1-2015 OH Health Exchange YES YES YES YES YES Interlink Interlink - Transplant must call Transplant Transplant only Transplant Only Kentucky Health Cooperative Kentucky Health Cooperative with First Health logo Going out of business. No appts after 12.31.15 KY Exchange Klais Health Network Klais Health Network - TERMED UC Students use UHC All Klais Health Network Workers Comp Ky Worker's Comp KY Unbridled Spirit KY Health Choices Unbridled Spirit KY Traditional Medicaid YES YES YES YES YES LifeSynch (used to be CorpHealth) Humana Life Synch Behavioral YES YES YES Maple Knoll Maple Knoll All YES YES YES YES YES Medicaid - Traditional OH Medicaid and State Name Medicaid YES YES YES YES YES Medical Mutual Medical Mutual HMO Mercy Health Medical Mutual HMO ProMedica Commercial Medical Mutual Managed Medicare MedMutual Advantage Choice HMO MedMutual Advantage Classic HMO MedMutual Advantage Premium PPO MedMutual Advantage Preferred PPO MedMutual Advantage Select PPO MMO Medicare In Network 1.1.16 Managed Medicare YES YES YES YES YES Medical Mutual Market Medical Mutual - look for Rx Group = MMOEXCH OH Health Exchange YES YES YES YES YES Medical Mutual of Ohio Medical Mutual Medical Mutual Supermed PPO Medical Mutual Access Mail Handlers Benefits Plan for Hospital but not Behavioral All YES YES YES YES YES Medical Mutual of Ohio / Careworks Careworks BWC Bureau of Workers Comp Ohio Worker's Comp YES YES YES YES Medicare - Traditional Medicare Medicare YES YES YES YES YES MediGold Managed Medicare MediGold Managed Medicare MetraComp (KY) MetraComp Worker's Comp Molina Dual My Care Ohio Medicaid Molina MyCare Molina There is no Medicare logo if it is only Medicaid portion of a dual Dual Medicaid portion YES YES YES YES YES Molina Dual MyCare Ohio Medicare Molina MyCare Molina (Medicare logo is present) Dual Medicare portion YES YES YES YES YES Molina Managed Medicaid Molina Medicaid (not part of a dual) Managed Medicaid YES YES YES YES YES Molina Managed Medicare Molina Medicare (not part of a dual) Managed Medicare YES YES YES YES YES Molina Market Place Molina Marketplace Molina Healthcare OH Health Exchange YES YES YES YES YES MultiPlan MultiPlan - Transplant must call Transplant Transplant only Transplant only Transplant only BCE Emergis, UP & UP, Foremost, Pro-America, Health MultiPlan (BCE Emergis, UP & UP, Foremost, Pro-America, Network, Health BPS, Wellmark, Network, BPS, Ohio Wellmark, Health, Med Ohio Network Health, Med Network) All YES YES YES YES please check with your physician. 4 2/5/2016
Mutual of Omaha Mutual of Omaha Commercial NPPN/PlanCare America- Plan Care America or NPPN HealthSmart label sometimes All YES YES YES YES YES Ohio Employee Health Partnership Ohio Employee Health Partnership Worker's Comp Ohio Health Choice Ohio Health Choice Access Ohio Health Choice Preferred Ohio Health Choice Select All YES YES YES YES YES Paramount Advantage Paramount Advantage OH Managed Medicaid YES YES YES YES YES Paramount HMO Network Paramount HMO Network Group number begins with "IX" OH Health Exchange Passport KY Passport Managed Medicaid Physicians Mutual Physicians Mutual Commercial PPOM/Cofinity Cofinity PPOM All YES YES YES YES YES Primary Health System/Careworks CareWorks BWC Worker's Comp Private Healthcare Systems PHCS Private Healthcare Systems All Protocol Tertiary Network Protocol Tertiary Network - Transplant must call Transplant Transplant only YES Transplant only Provider Select, Inc Provider Select All YES YES YES YES YES Queen City Hospice Queen City Hospice Hospice YES YES YES YES YES RiverLink Health RiverLink Health Managed Medicare Sagamore Health Network Sagamore Health All YES YES YES YES Senior Independence Hospice Senior Independence Hospice Hospice YES YES YES YES YES Summit Behavioral Health Summit Behavioral on back Behavioral Three Rivers Provider Network TRPN Three Rivers Three Rivers Provider Network All YES YES YES YES UC Health-UMR UMR UC Health All YES YES YES YES YES United Behavioral (UBH) Optum United Healthcare with Mental Health notation on back Optum Behavioral YES YES YES United HealthCare United Healthcare Other United Hlthcare Choice United Hlthcare Select United Hlthcare PPO UHC United Medical Resource United Hlthcare Indemnity United Hlthcare River Valley United Hlthcare Student Resource UnitedhealthOne(Golden Rule) United Hlthcare Navigate Plus Commercial YES YES YES YES YES United Healthcare - All Savers All Savers Commercial YES YES YES YES YES United Healthcare Exchange United Healthcare Compass OH Health Exchange United Healthcare Medicaid-Community Care UHC Community Care OH Medicaid please check with your physician. 5 2/5/2016
United Healthcare Medicare Advantage Plans UHC Select Medicare UHC Secure Horizons UHC Medicare UHC Medicare PFFS AARP Medicare Advantage In Network 1.1.16 Medicare Advantage YES YES YES YES YES United Healthcare Medicare PPO UHC Medicare PPO Comp In Network 1.1.16 Medicare Advantage YES YES YES YES YES United Resource Networks (URN) Optum United Resource Networks (URN) Optum - Transplant must call Transplant Transplant only YES Transplant only Transplant only University of Cincinnati Student Health Insurance United Hlthcare Student Resource All YES YES YES YES YES USA Commercial USA Medicare USA Managed Care Organization USA Work Comp All YES YES YES YES VA Choice HealthNet VA Choice HealthNet HealthNet Veterans Administration Veteran should present with a Referral Packette from the VA Govt YES YES YES YES YES Value Options Value Options Behavioral Veteran's Hospital No insurance card \; Veteran should present with a Referral Packette from the VA Also see VA Choice HealthNet Govt YES YES YES YES YES Vista Care USA Vista Care USA Hospice Vitas Hospice Vitas Hospice Hospice YES YES YES YES Wellcare of Kentucky WellCare Medicaid (to the right) KY Managed Medicaid YES YES YES YES YES Wellcare of Kentucky WellCare KY Medicare Managed Medicare Western Southern Western Southern Financial Group All YES YES YES YES Work Comp Network Patient has no card until a Case is created by the State Bureau of Worker's Comp; this is not a negotiated contract Worker's Comp YES YES YES YES please check with your physician. 6 2/5/2016