The following health insurance providers are accepted by Avita Health System physicians who are employed within North Central Ohio Family Care Center (NCOFCC) and all Avita facilities. Insurance plan acceptance is subject to change.

Prior to your medical visit, please contact your insurance provider to verify your Avita provider and/or facility accepts your insurance, and confirm your benefits and coverage. You may have network restrictions, co-payments, deductibles or other out-of-pocket expenses. Also, not all services may be covered by your insurance plan.

If there are any questions – please contact Patient Financial Services.

Definitions
Commercial – Provided through an employer or purchased directly with the insurance company 
Marketplace – Purchased through the Ohio Exchange    
Medicaid – State-administered, for low-income individuals and people with disabilities 
Medicare – Federally-funded, provides Part A and/or Part B Medicare benefits 
Military – Insurance for current or former military personnel and their families      
UHC Dual Complete – A UHC Medicare managed care plan where patient may also have Medicaid secondary

AARP

  • All Commercial Products
  • Medicare Advantage – HMO & PPO

Aetna

  • All Commercial Products – HMO, PPO, POS
  • Medicare Advantage – HMO, PPO, PFFS
  • Out-of-Network: Aetna Better Health of Ohio & Aetna MyCare Ohio

Anthem (Blue Cross Blue Shield)

  • Commercial Products (including Blue Cross & Blue Shield HMO, PPO)
  • Medicare Advantage – HMO, PPO, Dual Advantage
  • Marketplace Plans – Pathway
  • Out-of-Network: Blue High Performance Network (HPN) & Medicare Advantage SNP

Aultcare

  • Out-of-Network: All Products

Buckeye Health Plan (Centene)

  • Medicaid
  • Out-of-Network: Marketplace (Ambetter), Medicare Advantage Products (Wellcare by Allwell), & Buckeye MyCare Ohio

CareSource

  • Medicaid
  • Out-of-Network: Marketplace, Medicare Advantage Products, & Caresource MyCare Ohio

Cigna Healthcare of Ohio

  • All Commercial Products
  • Out-of-Network: Medicare Advantage Products

First Health – Galion Hospital & Bucyrus Hospital Only

  • Excluding No Contract Plans (not inclusive list)
    • Limited Benefit Plan
    • Minimum Essential Coverage
    • Practitioner Only
    • Practitioner & Ancillary Only
    • Discount Program

Gateway Health Plan – excluding Ontario Hospital

  • Medicare Advantage – HMO only

HealthSmart

  • Out-of-Network: All Products

HealthSpan

  • Out-of-Network: All Products

Humana

  • All Commercial Products – EPO, PPO, POS, HMO
  • Medicare Advantage Products – PPO, PFFS
  • Out-of-Network: Medicare Advantage Products (HMO only)

Interplan

  • Out-of-Network: All Products

Immergrun

  • Out-of-Network: App Products

Medicaid

  • Ohio Traditional
  • Breast and Cervical Cancer Project (BCCP)
  • Children with Medical Handicaps (BCMH)
  • Ryan White Program

Medical Mutual of Ohio (MMO)

  • Commercial Products
  • Medicare Advantage – HMO & PPO
  • Mutual Health Services
  • Out-of-Network: Marketplace Products & Medflex

Medicare

  • Traditional Medicare (A&B)
  • Medicare Railroad
  • Supplemental Health Plans

MediGold

  • Medicare Advantage – HMO & PPO

Medi-Share

Molina Healthcare of Ohio

  • Medicaid
  • Marketplace
  • Out-of-Network: Medicare Advantage Products & Molina MyCare Ohio

MultiPlan

  • Commercial Products
  • Excluding No Contract Plans (not inclusive list)
    • Limited Benefit Plan
    • Minimum Essential Coverage
    • Practitioner Only
    • Practitioner & Ancillary Only
    • Discount Program

Ohio Bureau of Workers’ Compensation (BWC)

Ohio Health Choice

  • All Commercial Products
  • OSU Health Plans (Prime Care Advantage)

OhioHealthy

  • Out-of-Network: All Products

OhioHealth Group – Some NCOFCC Providers only

  • HealthReach
  • Out-of-Network: HealthReach Preferred

Ohio PPO Connect

OSU Health Plans

Paramount

  • Advantage (Medicaid)
  • All Commercial Products (Prestige, Flex, or Preferred
  • Out-of-Network: Medicare Advantage Products (Elite) & Marketplace (Individual & SHOP)

SummaCare – except Ontario Hospital

  • All Commercial Products – HMO, PPO, POS
  • Medicare Advantage

TriCare

  • TriCare East – Humana Military
  • TriCare for Life – Secondary Insurance for Medicare Eligible Patients

UnitedHealthcare (UHC)

  • All Commercial Products – HMO, PPO, POS
  • Medicare Advantage – HMO, PPO, POS, Dual Complete
  • Community Plan (Medicaid)
  • VA – Community Care Network (Optum)
  • Out-of-Network: UnitedHealthcare MyCare Ohio

United Medical Resources (UMR)

  • UnitedHealthcare Network only

Valor Health Plan

  • Medicare Advantage HMO – SNP

Veterans Administration (VA)

  • VA – Community Care Network (Optum) – Through UHC Network
  • CHAMPVA

In-Network Insurance Companies

  • AARP
  • Aetna
  • Anthem (not High Performance Network)
  • Buckeye
  • Caresource
  • Cigna
  • Emerald (Ontario Hospital Out of Network)
  • First Health (Ontario Hospital and Avita Providers Out of Network)
  • Gateway Health HMO (Ontario Hospital Out of Network)
  • HealthSmart (Ontario Hospital Out of Network)
  • Humana
  • Interplan (Ontario Hospital Out of Network)
  • Medicaid
  • Medical Mutual of Ohio (not MedFlex)
  • Medicare
  • MediGold HMO & PPO
  • Molina
  • Multiplan
  • Mutual Health Services
  • Ohio Bureau of Workers’ Compensation (BWC)
  • Ohio Health Choice
  • Ohio PPO Connect (OPPC)
  • OSU Health Network
  • Ohio Health Group
  • Paramount Advantage Medicaid
  • Paramount Prestige, Flex, Preferred (Not Marketplace or Medicare)
  • SummaCare (Ontario Hospital Out of Network)
  • Tricare East & Tricare Prime
  • United Medical Resources (UMR)
  • United Healthcare
  • United Healthcare Community
  • Valor Medicare Health Plan HMO SNP

Ohio Marketplace Plans: In-Network

  • Anthem Pathway
  • Molina Marketplace

Crawford & Richland County Medicare Advantage Plans: In-Network

  • Aetna Medicare Advantage
  • Anthem Medicare Advantage HMO and PPO
  • Gateway HMO (Ontario Hospital Out of Network)
  • Humana PPO & PFFS
  • Medical Mutual of Ohio Medicare Advantage
  • MediGold HMO & PPO
  • SummaCare Medicare (Ontario Hospital Out of Network)
  • United Healthcare Medicare
  • Valor Medicare Health Plan HMO SNP

Out of Network

Avita is in network with most plans. This list of out of network plans is not comprehensive. It is always recommended that you contact your insurance company to confirm if a facility or provider is in network.

  • Anthem High Performance Network (HPN)
  • CareSource Marketplace and Medicare Advantage Plans
  • HealthSpan
  • Immergrun
  • Medical Mutual of Ohio Marketplace & MedFlex
  • Ohio Healthy (Ohio Health Employees)
  • Paramount Elite Medicare
  • Paramount Marketplace (Individual & SHOP)