What You Need to Know
The latest update
We’re committed to you and your care. We’re continuing to discuss a new contract with Cigna Healthcare that may impact your ability to access in-network healthcare from Cleveland Clinic.
If an agreement cannot be reached, your financial responsibility may increase because your insurance may no longer cover Cleveland Clinic care starting April 16, 2024.
Nothing changes for now
Right now, nothing changes, and you can continue scheduling appointments for care as usual.
We’re working hard to reach a new agreement and it’s our goal to avoid any changes that would disrupt your current healthcare coverage.
What You Can Do
Keep Cleveland Clinic in your network
Here’s what you can do to protect your in-network access to our providers in 2024:
- Call 216.255.5267 to speak with a representative.
- If you have a Medicare Advantage plan, you may consider your options during the Medicare Advantage open enrollment period, which runs through April 15, 2024, and choose a health plan that guarantees you’ll have access to in-network healthcare from Cleveland Clinic.
- If you have coverage through the Health Insurance Marketplace, you can contact the Health Insurance Marketplace at 800.318.2596 to see if you qualify for a Special Enrollment Period. If your request is not granted, you may file an appeal online at Healthcare.gov.
- If you have coverage through an employer-sponsored plan, speak to your employer about options during open enrollment and for updates about your in-network status and out-of-network benefits.
You can find a complete list of in-network insurance companies accepted at Cleveland Clinic by visiting ChooseClevelandClinic.org.
I’m a Florida Patient
Starting April 16, 2024, below are the Cigna Healthcare plans that will be out of network at Cleveland Clinic in Florida if an agreement cannot be reached:
- Employer-Sponsored Plans.
- Health Insurance Marketplace Plans.
- Medicare Advantage Plans.
I’m a Nevada Patient
Starting April 16, 2024, below is the Cigna Healthcare plan that will be out of network at Cleveland Clinic in Nevada if an agreement cannot be reached:
- Employer-Sponsored Plans.
I’m an Ohio Patient
Starting April 16, 2024, below are the Cigna Healthcare plans that will be out of network at Cleveland Clinic in Ohio if an agreement cannot be reached:
- Employer-Sponsored Plans.
- Medicare Advantage Plans.
Frequently Asked Questions (FAQs)
What is happening between Cleveland Clinic and Cigna Healthcare?
At this time, we’re discussing a new contract with Cigna Healthcare that may impact your ability to access in-network healthcare from Cleveland Clinic in Florida, Nevada and Ohio. We’re working hard to reach a new agreement to ensure our patients maintain their in-network access to Cleveland Clinic care.
Who’s impacted by these contract negotiations?
If you have health insurance from Cigna Healthcare through your employer, the Health Insurance Marketplace, or Medicare Advantage plan, your financial responsibility when seeking care at Cleveland Clinic may increase. Patients directly impacted will be notified.
Will my upcoming appointment be impacted?
If your appointment is before April 16, 2024, it will not be impacted by these negotiations.
What if I’m scheduled to receive care at Cleveland Clinic on or after April 16, 2024?
If you’re scheduled to receive care at Cleveland Clinic on or after April 16, 2024, you may call 216.255.5267 to request an appointment for an earlier date.
For care on or after April 16, all transition or continuity of care requests must be submitted to and approved by Cigna Healthcare. Please call the number on your Cigna ID card or 1.800.244.6224 to discuss your options with a Cigna Healthcare representative.
Important note: Beginning April 16, 2024, your financial responsibility may increase because Cigna Healthcare may no longer cover Cleveland Clinic care. Cigna Healthcare will determine which members can continue to be covered for services at Cleveland Clinic on or after April 16, 2024. This may require prior authorization before you receive care. Cleveland Clinic’s patient financial advocates can assist in obtaining a prior authorization from Cigna Healthcare.
Examples of medical conditions that may qualify for transition or continuity of care include:
- Pregnancy in the second or third trimester or considered high risk.
- Newly diagnosed or relapsed cancer.
- Trauma.
- Transplant care.
- Recent major surgery.
- Active treatment for acute conditions such as heart attacks, stroke, or unstable chronic conditions.
- Behavioral health conditions during active treatment.
Some patients with employer-based coverage and certain medical conditions may receive a notice with the option to “elect transitional care.” In that case, you can notify your plan that you choose this option, to help ensure coverage for an additional 90 days.
I've been pre-approved for services at Cleveland Clinic that take place on or after April 16, 2024. What should I do?
If you’re pre-approved for care taking place on or after April 16, 2024, you should contact Cigna Healthcare at the number on the back of your insurance card to discuss your options for continued care and determine if these healthcare services are still approved.
What if I’m admitted as an inpatient at Cleveland Clinic before April 16, 2024, but my hospital stay continues past this date?
Cleveland Clinic will work with Cigna Healthcare to determine the level of benefits available through your current insurance and inform you of your options for continued care.
How will this impact my out-of-pocket expenses?
If an agreement cannot be reached by April 16, 2024, your financial responsibility may increase because your insurance may no longer cover Cleveland Clinic care.
Will emergency care be impacted?
No. Emergency care will not be impacted by these negotiations.
Are Medicare Supplemental plans impacted by these negotiations?
No. Medicare Supplemental plans will not be impacted by these negotiations.
I have Cigna Healthcare dental insurance. What does this mean for me?
Patients with Cigna Healthcare dental insurance will not be impacted by these negotiations. You should continue to see your provider as you do now.
I don’t have Cigna Healthcare insurance. Does this impact my insurance, too?
No. These negotiations only affect you if you have Cigna Healthcare insurance coverage through your employer, the Health Insurance Marketplace or a Medicare Advantage plan. Cleveland Clinic accepts a variety of plans from insurance companies at all our locations. See a list of all accepted insurance plans at ChooseClevelandClinic.org.
How can I stay up to date on the negotiations?
We will provide updates about our ongoing negotiations through this website as new information is available. You can also call 216.255.5267 to contact our patient call center directly with any questions.
Last updated: 2/16/2024
