Which Insurance Plans Are Accepted At Cleveland Clinic
Below is the list of plans that are accepted at Cleveland Clinic main campus, our family health centers and community hospitals in Northeast Ohio.
The list below is for reference purposes only and is subject to change. Not all plans within the companies listed are considered participating. Always check with your health plan to confirm that Cleveland Clinic is included.
Is My Virtual Visit Covered By Insurance
Cleveland Clinic provides virtual visits for your convenience and health. Virtual visits are not covered by all insurance plans. In order to fully understand your benefits and potential cost, contact your insurance company and ask if virtual visits are included in your plan and if not, what it may cost you.
Find Out If We Accept Your Insurance: Text Us At 646
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We take many health insurance plans which are popular in NY, NJ, CT and PA including Aetna, Cigna, Blue Cross Blue Shield and UnitedHealthcare. We encourage you to consult with your healthcare insurance provider to confirm the plan imposes no special requirements for the provision of laboratory, pathology, or any other service.
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Does Aetna Cover The Cost Of Plastic Surgery
Aetna doesnt cover the cost of plastic surgery thats done exclusively for cosmetic purposes. However, surgeries or procedures done to ease pain or improve a body parts functioning may be covered, even if they alter the individuals appearance.
Aetna may also cover the cost of plastic surgery if its prescribed to:
- Correct a disfigurement caused by surgery or a traumatic injury
- Correct a congenital defect such as a cleft palate
- Reconstruct breasts after a mastectomy
- Treat individuals with gender dysphoria
- Reduce breast size to control headaches, back pain or skin breakdown
Dermatologists seeking approval for these and other plastic surgery procedures may need to submit documentation substantiating medical necessity. Documentation may include photographs, diagnostic imaging, patient records and any relevant correspondence between the physicians involved. If Aetna denies coverage for a procedure, participants or their physicians may file an appeal.
Does Aetna Cover Dermatology
Aetna health plans, including Medicare Advantage through Aetna, cover most types of preventive, diagnostic and medically necessary care, including medically necessary dermatology services. This might include a dermatology exam with your doctor if you’re concerned about potential skin cancer.
Because many dermatological treatments are used for both cosmetic and medically necessary care, individuals may have to meet specific clinical criteria prior to receiving approval for coverage. For example, skin tag removal may be covered if friction at the tag’s location causes irritation and bleeding, but Medicare won’t likely cover skin tag removal if it’s purely for cosmetic purposes.
Depending on the individual policy, plan participants may also need to satisfy additional criteria, such as receiving care from an in-network dermatologist or getting a referral from their primary care physician, and any applicable deductibles typically must be met before coverage kicks in. Some plans may also limit the number of times certain screenings may be performed each year.
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Does Aetna Have A Copay
Participants in some Aetna plans, including many HMOs and PPOs, must pay copays or coinsurance when visiting a dermatologist. The amount of this payment can vary depending on the individual policy and the services received. Depending on your plan, you may pay higher out-of-pocket costs if you visit a provider outside of the Aetna provider network.
Northeast Dermatology Associates Accepts Insurance
We accept the following insurance at Northeast Dermatology Associates. This list is for reference purposes only and is subject to change. Coverage is dependent on your individual benefits. If you have questions about your insurance coverage, please contact your carrier directly.
If you would like to speak with a representative at our billing office, please call or .
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Applied Behavior Analysis Medical Necessity Guide
The Applied Behavior Analysis Medical Necessity Guide helps determine appropriate levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.
Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member’s benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply.
The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered for a particular member. The member’s benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary.
Please note also that the ABA Medical Necessity Guide may be updated and are, therefore, subject to change.
How Can I Find A Dermatologist Near Me
If you need specialty care for a condition involving your skin, nails or hair, your primary care physician can typically recommend a dermatologist who accepts your insurance, or you can access a list of in-network providers directly through Aetna. You can find a reputable dermatologist through the American Academy of Dermatology’s dermatologist locator tool. Searches may be performed using a zip code or city and state.
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Where Can You Find Information About Your Specific Plan’s Coverage
Because dermatology coverage can vary widely by plan type, its important to understand what your individual policy covers and any requirements that must be met. This information is included in your plan documents, which are typically provided when your healthcare coverage begins. These documents contain information on covered services, plan requirements and applicable out-of-pocket costs. If you havent received your plan documents, contact Aetnas member services department to request a copy.
What Dermatology Services Arent Covered Through Aetna
Aetna typically doesn’t cover elective procedures done only for aesthetic purposes. For example, if a scar doesn’t cause pain or impair an individual’s ability to function, the cost of removal likely won’t be covered by Aetna. Purely cosmetic procedures may include:
- Laser hair removal
- Pulsed light laser treatments to reduce facial redness
- Removal or reduction of frown lines
- Depigmentation laser treatments
Aetna coverage may also exclude treatments and procedures that arent yet widely accepted by the medical community.
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Does Aetna Require A Referral To See A Dermatologist
Many Aetna HMO, EPO and PPO plans require a referral from a primary care physician before a participant may receive care from a specialist such as a dermatologist. However, other plans, such as the Aetna Open Choice PPO or the company’s indemnity plans, permit members to see an in- or out-of-network specialist without a referral.
Use The Links Below To Start Your Search
Doctor.com can help you find a Dermatologist who accepts Aetna insurance in Kentucky. A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
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We Do Not Accept The Following Plans:
- BCBS Anthem Pathway EPO
- BCBS Neighborhood
- Cigna Care 210 Network
- Cigna Connect Network HMO
- Health Choice Marketplace
- Humana Preferred Plan
- Humana Medicare
- Humana Gold Plus HMO
- Health Net Arizona Priority Care Network
- UHC AARP Oxford/UHC Oxford
- UHC Navigate/ONE
- UHC Medicare Solutions Pinal Health Network/Denver Metro Network
How Can I Find A Top
You can use Zocdoc to find Aetna Dermatologists who are highly rated by other patients. These ratings are based on verified reviews submitted by real patients. Every time a patient completes an appointment booked on Zocdoc, theyre invited to review their experience. Each review must comply with Zocdocs guidelines.
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How Can I Book An Appointment Online With An Aetna Dermatologist
Zocdoc is a free online service that helps patients find Aetna Dermatologists and book appointments instantly. You can search for Aetna Dermatologists by symptom or visit reason. Then, choose your location. Based on that information, youll see a list of providers who meet your search criteria, along with their available appointment slots.
You Might Be Surprised What You Can Search For
Of course, you can use our directories to find doctors and hospitals that take your insurance. You also can look for more than 25 other types of health care providers, including pharmacies, marriage counselors, urgent care centers, acupuncturists, drug and alcohol counselors, hospice care providers, dialysis centers, vision care providers, flu shot providers and physical therapists.
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Our Members Say It Best
Teladoc is not available internationally.
Teladoc is being provided to fully insured Aetna members and members of plans administered by Aetna. Teladoc is also provided to self-insured Aetna members and members of plans administered by Aetna whose employer has elected to offer the program to their employees. Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna or plans administered by Aetna. Teladoc is not available in all states. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services.*Limited to therapy only for eligible members ages 13-17. Teladoc does not provide psychiatric services or mental health medication management to adolescents.
How Can I Make A Same
On average, patients who use Zocdoc can search for a Dermatologist who takes Aetna insurance, book an appointment, and see the Dermatologist within 24 hours. Same-day appointments are often available, you can search for real-time availability of Dermatologists who accept Aetna insurance and make an appointment online.
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This Search Uses The Five
Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?
List Of Accepted Insurance Providers
- Aetna Open Choice PPO *SOI
- Aetna Choice POS II *SOI
- Managed Choice Open Access PPO
- National Advantage Program PPO
- Signature Authority PPO
- Blue Cross Advocate Centered EPO
- Blue Cross Blue Shield Illinois
- Blue Precision HMO
- Blue Advantage HMO
- Blue Cross Medicare Advantage PPO
- Choice Plus PPO
- Open Access Plus/Choice Fund OA Plus POS
- Coventry HMO & PPO
- Health Alliance POS, PPO, HMO, Plus
- HealthLink / Unicare PPO
- Humana Gold Plus HMO
- HumanaChoice PPO
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Are Video Visits With A Dermatologist Online Covered By Aetna
Most insurers provide coverage for video visits at the same cost as in-person visits. You can search on Zocdoc specifically for Dermatologists who accept Aetna for video visits by selecting your carrier and plan from the drop-down menu at the top of the page. We recommend you check with your insurance carrier directly to confirm your coverage and out of pocket costs for video visits.
Where Do I Get Started
We know that it can be stressful to navigate the insurance coverage process, but we strive to make it as smooth as possible.
We accept a variety of plans from insurance companies at all of our locations. To verify if your insurance plan is accepted for services across our health system, please review our list of accepted insurance companies below.
If your insurance company is accepted by Cleveland Clinic: Please contact your insurance company to confirm what care is covered by your plan as well as information on copayments, deductibles and coinsurance amounts. See what your out-of-pocket expenses will be using our cost estimator.
If your insurance company is not accepted by Cleveland Clinic: This means your insurance plan is considered out-of-network which can lead to greater out-of-pocket expenses for your care. Please contact your insurance company for more information about what your financial responsibility may be if you choose to receive care at Cleveland Clinic. Find more information about Cleveland Clinics out-of-network insurance process.
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