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.
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.
- Oscar Choice
- Anthem Pathway PPO
- Caresource Marketplace
Out of network:
- Anthem Pathway HMO
- Oscar Select
- Molina Marketplace
- Medical Mutual of Ohio (OhioHealth HMO)
- Buckeye Community Health Plan (Ambetter)
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: Healthcare.gov or insurance.ohio.gov/Consumer/Pages/FederalHealthReformFAQs.aspx.