Do you have a question about your healthcare insurance plan? Would you like to look over your health benefits? Is Nationwide Children's Hospital included as a provider for your child's healthcare needs? It is important that consumers are well informed about what your health plan does and does not cover.
Nationwide Children's Hospital is listed as a "preferred provider" for the managed care plans listed on our plan chart. Each provider shown on the chart has a link to their Web site. Remember that insurance plans vary, so from time to time our list may change. If you do not see your health plan listed on the chart, or you are not sure if Nationwide Children's Hospital is part of your healthcare network, we recommend that you call your health plan's customer service number or check with your employer's benefits manager. For help in selecting a physician for your child, visit our Physician and Services Locator, or call (614) 722-KIDS(5437) or 1-800-875-KIDS(5437).
Health Care Exchanges
On October 1, 2013, new health insurance options were made available to the American public as part of the Affordable Care Act (ACA). These new insurance plans provide another option for obtaining health insurance coverage. Currently, most individuals obtain insurance coverage by purchasing it themselves, via their employer, or are eligible for coverage provided by the government (eg, Medicare and/or Medicaid). The information provided here only addresses the new health insurance options being made available via ACA (aka “exchanges” or “exchange plans”). Additional information regarding the exchange plans is available through www.healthcare.gov.
This new online marketplace allows individuals to:
- Shop for health insurance options in their state
- Compare health plans
- Purchase and enroll in a health plan
The plans on the Health Insurance Marketplace are separated into 4 health plan categories — Bronze, Silver, Gold, or Platinum. Each metallic level varies by the percentage of costs you have to pay on average toward the health care you receive in the form of deductible, coinsurance, and/or co-payments. Review plan details of coverage carefully before choosing.
State-by-State Health Plans
Each state approved specific companies to sell plans on the exchanges. Many hospitals, including Nationwide Children's, do not contract with all of the plans in their state's exchange. It is important that individuals confirm that their child’s preferred providers are in-network prior to selecting a new plan on the exchange. A good number of the insurance plans have limited or no out-of-network benefits and individuals will be financially responsible for all unpaid charges. To insure you and your family do not incur any unexpected out-of-pocket expenses for your child’s care at Nationwide Children’s if you choose insurance through the new health care exchanges, Nationwide Children’s recommends that you enroll in one of the Ohio Exchange Plans listed in bold below with which Nationwide Children’s is contracted as an in-network provider.
*Note that this information is subject to change. Please re-check periodically for updates if your plan is listed as non-contracted.
Ohio Exchange Plans
Several companies will operate plans in Central Ohio, some of which are listed below. Note the plans at the top of the list, in bold, are the plans that are considered in-network for Nationwide Children's Hospital and its affiliated physician groups.
- Anthem BCBS PPO (Pathway)
- Caresource Marketplace
Out of Network:
- Anthem BCBS HMO (Pathway)
- Molina Marketplace
- Medical Mutual of Ohio (OhioHealth HMO)
- Buckeye Community Health Plan (Ambetter)
Learn more at www.areyoucoveredohio.org.
All Other States – Out of Network – Currently, Nationwide Children's Hospital is only contracted with Ohio Exchange Plans.
Please note that NCH is providing this information for general informational purposes only. NCH is not a Navigator and does not have any Certified Application Counselors on staff. We cannot provide you specific advice on how the new ACA health insurance marketplaces work nor can we sign you up for a plan. For additional information on the new health insurance exchanges please go to: www.healthcare.gov or insurance.ohio.gov/Consumer/Pages/FederalHealthReformFAQs.aspx.