Is Cleveland Clinic In-Network?

About Cleveland Clinic

Cleveland Clinic is a nonprofit academic medical center consistently ranked among the best hospitals in the world. Its main campus in Cleveland, Ohio serves patients from all 50 states and internationally. The Cleveland Clinic Health System also operates regional hospitals across Northeast Ohio including Fairview Hospital, Marymount Hospital, Lutheran Hospital, South Pointe Hospital, Hillcrest Hospital, and Medina Hospital, as well as outpatient facilities throughout the region and a major Florida campus in Weston.

The Cleveland Clinic Insurance Challenge

Cleveland Clinic is selective about which insurance plans it accepts, particularly for patients coming from out of state. Because of its national reputation, Cleveland Clinic has historically limited its participation in lower-reimbursement network products. This means patients with certain HMO, Medicaid managed care, or narrow-network marketplace plans may find Cleveland Clinic is listed as out-of-network even though they have insurance.

For Ohio residents, most broad commercial PPO plans — including those from Medical Mutual of Ohio, Anthem, SummaCare, and UnitedHealthcare — include Cleveland Clinic. The Clinic also has its own insurance product called “Synergy” for employers, which provides seamless access.

Cleveland Clinic Florida (Weston) and Insurance

Cleveland Clinic’s Florida campus in Weston participates in Florida-based insurance networks separately from the Ohio campus. Florida Blue, Aetna, and Cigna PPO products in South Florida commonly include the Weston campus. Patients visiting from out of state should confirm their home plan’s national network includes Cleveland Clinic Florida.

What to Do If Cleveland Clinic Is Out-of-Network

If you need care at Cleveland Clinic but it is out-of-network on your current plan, you have a few options:

• Single Case Agreement: Your insurer may negotiate a one-time in-network rate for a specific procedure at Cleveland Clinic. Ask your insurer’s case management team about this option, especially for complex or rare conditions.
• Plan Change: If it is Open Enrollment or you have a qualifying life event, switching to a plan that explicitly includes Cleveland Clinic may be worth the premium difference if you anticipate ongoing care there.
• Financial Counseling: Cleveland Clinic’s financial counseling team (1-800-223-2273) can explain self-pay rates and charity care options.