Insurance Plans Accepted

Managed Care Contracts

In an effort to better serve our patients and physicians, Southwest General has pursued contracts with many Managed Care Organizations (MCOs). We strive to develop contracts with companies who not only provide good medical coverage to their subscribers, but also who provide fair reimbursement and equitable contract terms. In addition to accepting traditional Medicare and Medicaid, Southwest has arranged special “managed care” contracts with the following entities:

Southwest General accepts all Medicare Private Fee For Service (PFFS) plans.


Aetna US Healthcare

  • HMO
  • Elect Choice (EPO)
  • Aetna Select
  • Aetna Select Open Access
  • Aetna Open Access Elect Choice (EPO)
  • Quality Point-of-Service (QPOS)
  • Managed Choice (POS)
  • Aetna Choice POS
  • Aetna Choice POS II
  • Aetna Open Access Managed Choice
  • Open Choice (PPO)
  • Traditional Choice Indemnity
  • Aetna Insurance Exchange
  • Aetna Medicare Advantage      HMO & PPO


Anthem Blue Cross and Blue Shield of Ohio

  • Blue Access PPO
  • Blue Access OH I & II              (prefix VXA,XVD)
  • Blue HMO
  • Blue Preferred HMO, POS, EPO
  • Blue Traditional
  • Blue Card PPO
  • Anthem Senior Advantage PPO, HMO
  • Anthem Medicare Preferred
  • Blue Medicare Access
  • Ford MHSA
  • HealthLink
  • Anthem Pathway X Tiered PPO—Marketplace
  • Anthem Pathway Tiered PPO—     Off Exchange


Beech Street

  • PPO


Behavioral Health Systems

  • Behavioral Health Only


Buckeye Community Plan

  • Medicaid
  • Buckeye HMO –Exchange
  • MyCare Ohio


CareSource Management Group

  • Medicare
  • Medicaid
  • MyCare Ohio

*NOTE—we are an out-of-network provider for Caresource Just 4 Me.  These patients are welcome to receive care at Southwest, but they may be responsible for higher out-of-pocket expenses. 


Cigna Behavioral Health

  • Behavioral Health Only


Cigna Healthcare of Ohio

  • HMO
  • PPO
  • Gatekeeper PPO
  • International


Emerald Health/InterPlan Health/HealthSmart

  • PPO


First Health Network/CCN/Coventry

  • PPO


Flora Health Network-PPOM

  • PPO


Gateway Health

  • Medicare

Health Design Plus

  • UH Choice RTA


Health Ohio Network

  • PPO

Healthstar/PPO Next

  • PPO


Horizon Health

  • Behavioral Health Only


Humana

  • Commercial PPO, HMO, POS, EPO
  • Commercial HMOx
  • Medicare PPO, HMO
  • Medicare Network PFFS


Marymount Behavioral Health Services

  • Behavioral Health Only


Medical Mutual of Ohio

  • Traditional
  • SuperMed Select
  • SuperMed Classic
  • Supermed HMO
  • HMO Health Ohio
  • Medical Mutual Exchange
  • Medicare Advantage


Molina

  • Medicaid
  • Marketplace Exchange


National Provider Network

  • PPO


Northcoast HealthCare Management

  • Home Health/Home Infusion


Ohio Bureau of Workers' Compensation (BWC)

  • All BWC MCO's


Ohio Health Choice Plan/Ohio Health Choice Plus

  • PPO
  • EPO


PHS/Direct Care America

  • PPO


Private Healthcare Systems (PHCS)/MultiPlan

  • PPO
  • POS


Summa Care

  • HMO, PPO, POS
  • Medicare Advantage
  • Apex PPO, EPO and POS
  • SummaCare Exchange


United Behavioral Health

  • Behavioral Health Only


United Healthcare

  • HMO, PPO, POS
  • Medicare HMO
  • Secure Horizons (Medicare)
  • Evercare Medicare
  • United Healthcare Community  Plan (Medicaid)
  • All Savers              
  • Compass –Exchange
  • MyCare Ohio


Beacon Health (Value Options)

  • Behavioral Health Only


Periodic updates of this list may occur. If you have any questions or require additional information, or if you would like to make suggestions for our contracting efforts, please contact Michelle Cinquepalmi at 440-816-6779.

This list is meant to be a basic guide and not provide detailed information. 

EPO Exclusive Provider Organization
POS Point of Service Plan
HMO Health Maintenance Organization
PPO Preferred Provider Organization