Contracted Health Insurance Networks and Determining Patient Payment

Out-of-pocket expenses for insured patients are impacted by multiple factors, including the benefit plan with their insurance, the contracted reimbursement rate between Premier and the insurer, and whether the patient and/or their family has already met certain deductible thresholds.

Most Premier Health patients have health insurance through the following networks, most of which are contracted with Premier Health hospitals and physicians as in-network providers except where noted. The below table is a guide, so please contact your insurance company to confirm Premier Health is included in your plan's network of participating providers.

Insurance Plans & Products – Contract Status

 

Commercial Insurance Networks

 

Medicare HMO/PPO Networks

 

Medicaid Managed Care Plans

 

Health Insurance Marketplace/Exchange Plans

 
Most Frequent Plans  
Aetna   Yes Yes Yes-MyCare  
Anthem/Blue Cross Blue Shield   Yes Yes    
Humana   Yes* Yes    
Medical Mutual   Yes, including Med-flex HMO Yes    
United HealthCare   Yes Yes No  

Insurance Plans & Products – Contract Status

 

Commercial Insurance Networks

 

Medicare HMO/PPO Networks

 

Medicaid Managed Care Plans

 

Health Insurance Marketplace/Exchange Plans

 
All Plans  
Aetna   Yes Yes Yes-MyCare  
Ambetter by Buckeye     No   No
Anthem/Blue Cross Blue Shield   Yes Yes    
Buckeye     Yes Yes-Medicaid & MyCare No
CareSource     No Yes No**
Cigna/Great West   Yes      
First Health/Coventry   Yes      
Gateway Health     No    
Healthsmart   Yes      
Humana   Yes* Yes    
Medical Mutual   Yes, including Med-flex HMO Yes   Yes
MediGold     No    
Meridian   Yes    
Midwest Health Collaborative (MHC)   Yes      
Molina     No No No
Multiplan   No      
Ohio Health Choice/Ohio PPO Connect   Yes      
Paramount   No No Yes No
Premier Health Plan/Premier Health Advantage   Yes No    
Private Healthcare Systems (PHCS)   Yes      
Tricare/Humana Military   Yes      
United HealthCare   Yes Yes No  
United Behavioral/Optum Health   Yes Yes    


* Premier is not contracted with Humana's Cincinnati/Northern KY HMOx Exchange plans
** CareSource's exchange plan will list "Marketplace" on it. All other plans will just say, CareSource
Where blank, a product is not available or applicable in the Premier service area 

Content Updated: March 29, 2019

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