Insurance Information
Akron Children’s Hospital List of Accepted Insurance Plans
Please note:
Akron Children’s contracts with many of the health insurance companies listed below (known exceptions are highlighted in italics). If you want to know the details of what your health plan covers, please call the phone number on your insurance card.
If you get your insurance through an employer that is self-funded, the benefit plan can vary, and there may be narrow networks or tiered benefits that may or may not include Akron Children’s.
Even if Akron Children’s has a contract with your insurance company, some doctors and providers may not be fully approved. They must finish a process called “credentialing” with your insurance company first.
If your insurance company is on this list, it doesn’t mean they will pay for all services provided at Akron Children’s. Certain products or services may be excluded.
This list is for reference purposes only, it may change, and it does not guarantee payment for services. Please contact your insurance company to confirm all covered services.
Contracted Health Insurance List:
Aetna (Except the following: Cleveland Clinic Employee Health Plan (EHP)
Aetna-CVS Health Marketplace Plan
Aetna Better Health OhioRise (Ohio Medicaid)
Aetna Better Health of West Virginia (West Virginia Medicaid)
Aetna Dental
Aetna Vision
America’s Choice Provider Network
AmeriHealth Caritas (Ohio Medicaid)
AmeriHealth Caritas (Pennsylvania Medicaid)
Anthem/Blue Cross Blue Shield (Except the following: Blue High-Performance Network, Highmark HMO and POS, CHIP Highmark Healthy Kids, Highmark Keystone, Anthem Pathway or Pathway X plans including prefixes-JWR, JWV, JWT, YFS, YSY or Prime Healthcare prefix-PHU, or University Hospitals Employee Medical Plan prefix-VUHS)
Anthem Blue Vision
Anthem Dental
Anthem Medicaid (Ohio Medicaid)
Anthem Medicare Plan
Anthem Dual Special Needs Plan
Antidote Marketplace Plan
AultCare
AultCare Marketplace Plan
Beechstreet
Buckeye Health Plan (Ohio Medicaid)
CareSource (Ohio Medicaid)
CareSource MyCare
Cenpatico Behavioral Health
Cigna
Cigna Dental Care Access
Cofinity
Delta Dental
Dentegra Dental
DenteMax Dental
DentaQuest Dental (Ohio Medicaid)
Dental Care Plus Dental
Enterprise Group Planning
Envolve Dental (Ohio Medicaid)
Envolve Vision (Ohio Medicaid)
Evernorth Behavioral Health
EyeMed Vision (Ohio Medicaid)
EyeQuest Vision
First Health Network
GEHA-United Healthcare Choice Plus network
GEHA Dental
Guardian Dental
HealthSmart (DirectCare America/Primary Health Services)
Highmark Wholecare (Pennsylvania Medicaid- Except the following: Medicaid Assured plans)
Humana (except the following: Medicare)
Humana Dental
Humana Healthy Horizons (Ohio Medicaid)
Liberty Dental (for Anthem Ohio Medicaid members only)
Magellan Behavioral Health
March Vision (Ohio Medicaid)
Marietta Memorial Health System/MedBen
Medical Mutual including MedFlex (Except the following: Medicare, CLE-Care HMO, or MetroHealth Skyway/Skycare plans - unless verification of benefits indicates ACH is in-network)
Medical Mutual Individual HMO Network Marketplace Plan
Medical Mutual Traditional Vision
MetLife Dental
Molina Healthcare (Ohio Medicaid)
MultiPlan
Northern Ohio Handicap Fund (NOHF)
Ohio Crippled Children’s Fund (OCCF)
Ohio Health Choice (Ohio PPO Connect)
Ohio Health Group
Ohio Preferred Network
OSU Health Plan/Avita Health System
Paramount Marketplace Plan
Paramount-Hospital services only (Except the following: Medicare)
Pennsylvania Traditional Access (Pennsylvania Medicaid)
Preferred Provider of Michigan (PPOM)
PrimeNet
Principal Plan Dental Network
Private Health Care Systems (PHCS)
Quality Care Partners (QCP)
SkyGen Dental (Ohio Medicaid)
Spectera Eyecare Vision
SummaCare
SummaCare Marketplace Plan
SummaCare Medicare Plan
Superior Vision (Ohio Medicaid)
The Health Plan (Except the following: West Virginia Public Employees Insurance Agency (PEIA)
The Health Plan Medicare Plan
The Health Plan of West Virginia (West Virginia Medicaid)
TriCare/Humana Military (Except the following: TriCare Prime Remote Service area)
United Behavioral Health (UBH/Optum)
United Healthcare (Except the following: MyCare or Medicare)
United Healthcare Commercial Dental
United Healthcare Marketplace Plan
United Healthcare Community Plan (Ohio Medicaid)
United Healthcare Community Plan Dental (Ohio Medicaid)
UPMC Commercial–Pediatric Burn Only–if medical approval received, contracted via MMO network.
UPMC For You (Pennsylvania Medicaid)
Wellpoint West Virginia (West Virginia Medicaid)
Non-Contracted Health Insurance List:
Anthem Marketplace Plan
Anthem MyCare
Buckeye AmBetter Marketplace Plan
Buckeye MyCare
Buckeye Wellcare Medicare
CareSource Marketplace Plan
Carelon Behavioral Health
ComPsych Behavioral Health
Geisinger Health Plan (Pennsylvania Medicaid)
Health Partners Plan (Pennsylvania Medicaid)
Highmark Health Options (West Virginia Medicaid)
Keystone First (Pennsylvania Medicaid)
Molina Marketplace Plan
Molina MyCare
Oscar Marketplace Plan
SkyGen Dental (West Virginia Medicaid)
SpringTide Health
United Healthcare Community Plan (Pennsylvania Medicaid)
United Healthcare Medicare HMO
United Healthcare MyCare
UPMC Commercial Plans
VSP Vision
When we contract with health plans, our goal is to include all Akron Children’s Hospital services. However, even if Akron Children’s Hospital is listed in your health plan’s Provider Directory as a participating or preferred hospital, it does not always mean that all Akron Children’s services are covered.
You should call the Member Services Department of your health plan or your employer’s Human Resources Department for questions related to the covered benefits of your health plan. Benefit plan designs can be unique by employer, as some employers create narrow networks or tiered benefits for their health plans.
- Questions to Ask:
- When checking to see if your child can receive services at Akron Children’s, here are key questions you should ask your health plan:
- Specific Services: Are specific services covered such as Outpatient Laboratory, Physical or Occupational Therapy, Behavioral Health, Home Health Care, etc.?
- Specific Doctors: Is a specific doctor a participating provider in my health plan and are they fully effective with the plan? Akron Children’s may be contracted with your health plan, but the provider may not be fully participating until their credentialing paperwork is complete.
Out-of-Pocket Costs: Are there any out-of-pocket costs I may incur?
Always check with your health plan for the most up-to-date coverage and network participation levels of coverage.
Insurance FAQ
Does Akron Children’s take my insurance?
Benefit plan design can be unique by employer (e.g., narrow networks, tiered benefits, etc.), so it is best for patients and families to call their insurance company to confirm if Akron Children’s is in-network with your insurance. You can call the Member Services phone number on the back of your Member ID card. See the Akron Children’s Hospital list of accepted insurance plans.
How do I find a pediatrician that accepts my insurance?
To find a pediatrician that accepts your insurance you should call the Member Services phone number on the back of your insurance card or check your insurance companies’ website for a list of providers that are in-network.
My insurance changed who should I notify?
If your health insurance has changed, please call your physician’s office, and notify them of your new insurance coverage.
Do you offer services for patients that have out-of-state insurance?
To find out if your insurance covers out-of-state medical care you should call the Member Services phone number on the back of your insurance card to check if your benefit plan will include these services. If you have commercial insurance through your employer, you can also contact you employer’s HR department.
Does Akron Children’s accept out-of-state Medicaid plans?
ACH is contracted with several Pennsylvania and West Virginia Medicaid plans. States have regulations which typically require their members to receive services, if offered, in their home state. Otherwise, all other out-of-state Medicaid patients should be referred to their State Medicaid or Medicaid Managed Care plans to receive scheduled/planned services.
How much will my procedure/service/appointment cost?
Patients can get an estimate for common procedures at Akron Children’s Hospital under Services/Price Estimates at https://www.akronchildrens.org/pages/Financial-Services.html. You can also call the Akron Children’s Financial Counseling Department at 330-543-2455.
Will this procedure/service/appointment be covered by my insurance?
Coverage under a patient’s benefit plan can be verified by contacting your insurance company. It is very important to validate this information as a first step by calling the Member Services number on the insurance ID card or visiting the insurance company website. For patients with commercial insurance, the plan design offered by the employer to its employees determines whether the service is a covered benefit or not. A patient/family can also call their employer’s HR department for benefit plan detail and Summary Benefit Coverage.
I have a question about a balance on my bill.
If you have questions about a bill call Akron Children’s billing office Customer Service team at 330-543-8500.
Why was my insurance not billed?
If you have questions about a bill call Akron Children’s billing office Customer Service team at 330-543-8500.
How can I apply for a payment plan for my bill?
To set up a payment plan with a Financial Counselor call 330-543-2455.
How do I apply for Financial Assistance?
To schedule an appointment with a Financial Counselor call 330-543-2455. To schedule online, log in to MyChart. Select the patient’s name. Click on “Schedule an Appointment,” and then click on “Financial Counseling.”
Akron Children’s offers a financial counseling program to help families apply for third-party coverage from commercial insurance companies, Medicaid, and other state and local programs. If insurance coverage is not available, Financial Counseling will help families find other financial help they may be eligible to receive.
How to Apply for Financial Assistance:
The Financial Assistance Application, Financial Assistance Policy and this Plain Language Summary are available in different languages.
- Call a financial counselor at 330-543-2455 and request a free copy to be mailed or emailed
- Email our financial counselors at FinCounsel@akronchildrens.org to request a copy via mail or email
- Write to Financial Counseling at One Perkins Square, Akron, OH 44308 and request that copies be mailed, free of charge
- Go in person to our Admitting Office located on the third floor of the Main Hospital Building on our Akron Campus at 214 W. Bowery Street, Akron, OH, 44308
Documentation Requirements:
To apply, you must provide documentation to verify any information that may affect your eligibility, including information regarding your place of residence and income.
More information can be found on the financial assistance page.
To find a pediatrician that accepts your insurance you should call the Member Services phone number on the back of your insurance card or check your insurance companies’ website for a list of providers that are in-network.
See the Akron Children’s Hospital list of accepted insurance plans.
Are you wondering what a procedure will cost? Get an estimate for common procedures from one of our locations near you.
What is an estimate?
An estimate is the predicted amount you will pay for a medical service based on your insurance and what patients have been charged in the past.
How accurate are estimates?
Prices may vary and an estimate is not a quote or guarantee. We try our best to give you an accurate estimate, however many factors go into the final cost. The actual price you pay may be higher or lower than the estimate.
How do I get an estimate?
If you have a MyChart account, you may use your MyChart app to get an estimate.
Don’t have MyChart? Click here for an estimate or Contact a financial counselor.
In compliance with state law, Akron Children’s is providing this price list, which includes charges for room and board, emergency department, operating room, physical therapy and other procedures. The hospital’s charges are the same for all patients, but a patient’s responsibility may vary, depending on payment plans negotiated with individual health insurance companies. Uninsured or underinsured patients should consult with our admitting and billing staff to determine whether they qualify for discounts. The prices listed are our standard fees before insurance, and are correct as of Jan. 1 of the current year.
You may contact the staff at 330-543-8500, or 1-800-933-7440.
There are two ways to schedule:
- To schedule by phone, call 330-543-2455
- To schedule online, log in to MyChart. Select the patient’s name. Click on “Schedule an Appointment,” and then click on “Financial Counseling.”
You will need the following documentation for your appointment with a financial counselor:
- Driver’s license or valid ID
- Utility bill for proof of address
- Pay stubs from the previous month
- Proof of pregnancy (if applicable)
- Health insurance information (if applicable)
- Social security numbers for all family members Akron Children’s is dedicated to providing medical care to infants, children, teens and burn victims of all ages, regardless of their ability to pay.
Currently, there is no charge for the vaccine itself. We may bill your insurance a vaccine administration fee as this helps us support the costs of the public vaccination program. However, you will not be required to make a co-pay at the visit. In addition, you will not receive any bill or “balance bill” from Akron Children’s regardless of whether your insurance pays or not. We will still give you the vaccine at no charge even if you are uninsured or your insurance does not cover the vaccine.
