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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 Commercial

  • HMO
  • Elect Choice (EPO)
  • Aetna Select / Select Open Access
  • Aetna Open Access Elect Choice (EPO)
  • Quality Point-of-Service (QPOS)
  • Managed Choice (POS)
  • Choice POS & POS II
  • Open Access Managed Choice POS
  • Open Choice (PPO)
  • Aetna Affordable Health Choices
  • Aetna Health Network Only
  • Aetna Health Network Option
  • Aetna HealthFund
  • Aetna Premier Care Network (APCN) /Plus
  • Savings Plus of Ohio-HNO
  • Ohio HealthNetworkOption
  • Ohio Open Choice PPO
  • Aetna with Innovation Health – Aetna Select, POS, PPO
  • National Advantage Program (NAP)

Aetna Medicare Advantage

  • Aetna Medicare HMO & PPO
  • Aetna Medicare ESA PPO
  • Aetna Medicare Premier 1 & 2 PPO
  • Aetna Medicare Premier Plus PPO
  • Aetna Medicare Value Plan PPO
  • Aetna Medicare Premier HMO
  • Aetna Medicare Value Plan HMO
  • Aetna Medicare Advantra PPO
  • Aetna Medicare Advantra ESA PPO
  • Aetna Medicare Advantra Silver
  • PPO

Aetna Other Government

  • Aetna Medicare HMO Dual SNP (DSNP)

Anthem BCBS Commercial

  • Blue Access PPO
  • Balanced Blue Access PPO
  • Blue Access Options PPO (OH I &II) (prefix VXA,XDV, YKY)
  • Blue HMO
  • Blue Preferred HMO, POS, EPO
  • Blue Preferred Plus POS
  • Blue Traditional
  • National PPO (Blue Card PPO)
  • Bronze Blue Access PPO & PPO Plus
  • Gold Blue Access PPO
  • Lumenos Plans
  • Ohio Med Plan
  • Platinum Blue Access PPO
  • Silver Blue Access PPO & PPO Plus
  • Anthem Federal Employee Plan

Anthem Medicare Advantage

  • Anthem Senior Adv. PPO, HMO
  • Anthem MediBlue Preferred HMO
  • Blue Medicare Advantage PPO
  • Anthem MediBlue Access PPO
  • Anthem MediBlue Access Basic (Regional PPO)
  • Anthem MediBlue Access Core (Regional PPO)
  • Anthem MediBlue Access Plus (PPO)
  • Anthem MediBlue Dual Advantage
  • Anthem MediBlue Essential HMO
  • Anthem MediBlue Extra HMO
  • Anthem MediBlue Plus HMO
  • Medicare Select

Behavioral Health Systems

  • Behavioral Health Only

Beech Street - PPO

Bright Health Medicare Advantage

  • Bright Advantage HMO
  • Bright Advantage Flex PPO

Buckeye Community Plan

  • Medicaid
  • AllWell Medicare Advantage
  • Ambetter (Exchange HMO)
  • MyCare Ohio

CareSource

  • Medicare
  • Medicaid
  • MyCare Ohio, D-SNP
  • Marketplace (Exchange)

Cigna Behavioral Health

  • Behavioral Health Only

Cigna Healthcare of Ohio

  • HMO, PPO
  • Choice Fund PPO
  • Gatekeeper PPO
  • International
  • Open Access Plus
  • Choice Fund OA Plus

ClaimDoc

Devoted Health EFFECTIVE 1-1-21

  • Medicare Advantage

HealthSmart PPO

First Health/CCN/Coventry

  • PPO

Health Design Plus

  • UH Choice Network –

Cleveland Metropolitan School

Health Ohio Network PPO

Healthstar PPO/PPO Next

Horizon Health- Behavioral Health Only

Humana

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

Marymount BH Services

  • Behavioral Health Only

Medical Mutual of Ohio

  • SuperMed PPO
  • SuperMed Classic
  • SuperMed HMO
  • SuperMed Preferred
  • SuperMed Traditional
  • Ohio Med
  • MedFlex
  • MMO Exchange/Individual
    • NE Ohio HMO
  • Medicare Advantage HMO & PPO

Molina

  • Medicaid
  • Marketplace Exchange

Northcoast HealthCare

  • Home Health/Home Infusion

Ohio Bureau of Workers' Comp

  • All BWC MCO's

Ohio Health Choice Plan/Ohio

Health Choice Plus – PPO

PHS/Direct Care America - PPO

PHCS/MultiPlan - PPO & POS

SummaCare

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

United Behavioral Health (Optum)

  • Behavioral Health Only

United Healthcare

  • Commercial Plans
    • Core Essential – EPO & POS
    • Choice HMO & EPO
    • Choice Plus POS
    • Nexus – ACI, EPO, POS, HMO
    • Heritage POS River Valley – Choice
    • UHC Doctors Plan/ Plus – HMO, EPO, POS
    • PPO
    • UHC Charter / Charter Plus
    • Select – HMO, EPO
    • Select Plus POS
    • Navigate / Navigate Plus
    • All Savers
    • GEHA
  • Government Plans
    • UHC Medicare PPO & HMO
    • AARP Medicare Complete Plans
    • UHC Medicaid
    • UHC MyCare Ohio (UHC Connected Care)
    • UHC Dual Complete – HMO SNP & HMO-POS SNP

Beacon Health (Value Options)

  • Behavioral Health Only

Veterans Community Care Network (VA CCN) – through Optum/UHC

  • Please note – Providers must have an approved referral from the VA prior to rendering Service Connected Care.

Non-Contracted Insurance Plans

Anthem Medicare Advantage

  • Anthem MediBlue Prime Select (HMO) – exclusive to Cleveland Clinic

Medical Mutual

  • Mercy Health HMO network plans – exclusive to Mercy Health
  • CLE-Care HMO – exclusive to MetroHealth

True Cost Plans

  • Liberty HealthShare
  • Group & Pension Administrators

Paramount

  • Medicare
  • Medicaid

SummaCare Exchange

  • Exclusive to Summa Health System, Mercy Medical Center (Canton) and Akron Children’s Hospital

Cleveland Clinic/Oscar health plans – exclusive to Cleveland Clinic

Humana Medicare Advantage

  • Humana Cleveland Clinic Preferred (HMO) & Humana Cleveland Clinic (HMO SNP-DE) – both plans are exclusive to Cleveland Clinic

*Please note this is not a complete list of non-contracted insurance plans, these are the most common plans.


This list is meant to be a basic guide and not provide detailed information. 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 us at 440-816-6779 or 440-816-8668.

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