Provider Lookup Video Tutorial
Tutorial video on how to search for your providers and facilities
During this year’s open enrollment beginning Oct. 20 through Nov. 4, you will have the opportunity to select from two medical insurance options — EHP and EHP Plus. Because the plans have different networks, we encourage you to review which plan is right for you and your family.
The EHP Website is your hub to learn all about your medical benefit options ahead of open enrollment. New information this week includes:
Note, Aultman Hospital and affiliates may appear in network in 2022. As of 2023, Aultman Hospital and all affiliates will be out-of-network for EHP, EHP Plus and all EHP plans.
Remember, in 2023 there will no longer be out-of-network coverage for the EHP and EHP Plus plans except for urgent or emergency care.
Continue to check this site as we work on completing the network for 2023.
Cleveland Clinic is invested in your health and well-being, and we look forward to continuing to offer comprehensive healthcare benefits and a competitive My Pay + Benefits package.
Yes, if you want healthcare benefits through Cleveland Clinic in 2023.
During open enrollment, you will have the choice between two health plans in Workday:
1. Employee Health Plan (EHP)
2. Employee Health Plan Plus (includes a national network of providers)
The EHP offering includes Cleveland Clinic providers, in addition to Quality Alliance providers.
Please note: Akron Children’s Hospital is not included in the EHP network.
The EHP Plus offering gives members access to the providers available in the EHP plan (above), PLUS Aetna's Open Access Select network, which includes providers nationwide. Akron Children’s Hospital is included in the EHP Plus network.
Both plans offer the same benefits and coverage, while premium and network size differ. The choice is up to you when you make your health plan elections during open enrollment.
You must take action during open enrollment by logging into Workday and electing either the EHP or EHP Plus plan. More details on these health plans and the enrollment process will be made available as we get closer to open enrollment, Oct. 20 – Nov. 4.
Provider search links are available above for each network for you to see whether current providers will be covered for you in 2023.
When deciding on which plan to select for 2023, you are strongly encouraged to check all of your current providers to see if they are listed in your new network choice. You are expected to receive all your care from the providers in the network you choose.
As the 2023 plan year begins, there may be certain situations in which you are finishing a treatment that is already started and need more time to switch to an in-network provider. In this instance, a brief and temporary transition-of-care coverage for the out-of-network provider may be available. Restrictions apply and situations are limited. Find the most current Transition of Care form at https://employeehealthplan.clevelandclinic.org/. Bookmark this site to find current information on eligibility and the process of requesting temporary transition-of-care coverage in 2023.
Yes, you need to ask for a TOC waiver if your OB provider is not in your network and you are experiencing a high-risk pregnancy, or if you are having a routine pregnancy and are at 20 weeks or more gestation as of Jan. 1, 2023.
If your provider(s) is a Cleveland Clinic or Cleveland Clinic Quality Alliance provider, they will be in network for both EHP and EHP Plus in 2023. It is your responsibility to verify the participation of your provider in the networks. Please reference the Aetna provider search tools to identify physicians and facilities covered in each of the plans.
No. Services provided by these medical institutions and their affiliates are not covered by either the EHP or EHP Plus health plan in 2023. In case of an emergency, services will be covered and if admitted, will be subject to the notification and transfer requirements outlined in the Summary Plan description.
In 2023, Akron Children’s Hospital will be available to any caregiver who elects EHP Plus during open enrollment. If you would like to maintain your coverage for Akron Children’s Hospital, you must elect EHP Plus. There will be no coverage for Akron Children’s Hospital under the EHP plan in 2023.
With the geographic expansion and growth of Cleveland Clinic, it is necessary to offer a plan that accommodates the needs of our caregivers nationwide. The EHP Plus plan will serve this purpose as we continue to grow. EHP Plus includes a wider network of providers in addition to Cleveland Clinic and Quality Alliance providers. The benefit coverage is the same for both EHP and EHP Plus, with no deductible and lower copays.
Providers who are included in the Cleveland Clinic Quality Alliance or Aetna Select Open Access networks will be covered if you elect EHP Plus. As long as your specialist is participating in either of these networks, they are considered in-network and services will be covered. You can access the provider search tool for the EHP Plus plan to confirm that your specialist participates in the Aetna Select Open Access network.
A referral is not required to see a specialist in EHP or EHP Plus.
The EHP plan has a large network of Behavioral Health providers who are aligned to the Quality Alliance and are in-network providers.
The EHP Plus wide access plan includes the Cleveland Clinic Quality Alliance and all the national Aetna Select Open Access network providers. Before open enrollment, you will be able to search providers for each plan using the links in the “How do I know if my provider is in the network?” FAQ above. There is no out-of-network coverage in either plan, except emergency or urgent care.
Although the cost of the EHP Plus plan is more than the EHP plan, it is competitively priced and has low out-of-pocket expenses for an open access network. Under the EHP Plus option, you receive access to the Aetna Select Open Access network. Because the EHP Plus option has access to nationwide providers, the cost will be higher. EHP and EHP Plus are rich plans, meaning their benefit designs do not have any deductibles, and they have minimal copays and co-insurance. In addition, your Healthy Choice participation helps lower your premium costs. As a reminder, active caregivers are able to offset the cost of their health, dental, vision and supplemental life elections by trading in their PTO.
No, the current prescription drug plan will continue to be managed by the EHP Pharmacy Management Department and administered by CVS/Caremark.
The EHP Prescription Drug Formulary can be found on the EHP website, along with other information related to the EHP Prescription Drug Benefit Program. Medications may be added to the EHP Prescription Drug Formulary four times a year and removed from the EHP Prescription Drug Formulary twice a year, once at the start of the benefit year in January and again at mid-year in July.
Yes, the Prescription Drug Benefit Program is the same for both EHP and EHP Plus members.
EHP and EHP Plus members can utilize any of the CVS store pharmacies, including those located inside Target stores, to obtain acute need prescription medications. Please note the charge will apply to your annual pharmacy deductible even if you fill the prescription with a generic medication.
Yes. Starting in 2023, your vision exams are covered under the EHP and EHP plus health plans. You also have the option to enroll in our vision plans, which provide discounts on glasses and contacts. More information about vision plan coverage will be provided closer to the open enrollment period.
No, your current Aetna Health account will update with your new plan selection on or after Jan. 1, 2023. Your 2022 claims history will still be available and visible on Aetna Health.
Yes, look for new medical ID cards in the mail prior to January 2023. Please be sure your address is up-to-date in Workday prior to open enrollment and remember to use your existing medical ID cards through December 2022 for services.
If you previously set up an Aetna Health account, your new 2023 medical ID cards will update and display with the EHP or EHP Plus plan you selected during open enrollment. The new card will display in Aetna Health on or after Jan. 1, 2023.
Through the end of 2022, there is no impact to your retiree medical benefit if you choose to elect that coverage as part of your retirement process. The same two EHP and EHP Plus options will be offered to you for 2023. More information will be provided to you during the retirement process. If you plan on retiring, report your retirement date to the ONE HR Service Center to start the retirement process.
If you are currently on COBRA, you can continue coverage under your current plan for the rest of 2022. You will receive an open enrollment notification from Payflex in the fall, and at that time, you will have the opportunity to elect coverage for 2023 and choose between EHP and EHP Plus.
In order for the balance to be paid, you must see a provider in the EHP network (Cleveland Clinic Quality Alliance). If you’ve selected EHP Plus, you must see a provider in the EHP Plus network (Aetna Select Open Access).
Eligible dependents who are away at school, like college students, are covered no matter which plan option is selected, EHP or EHP Plus, as long as they use in-network providers for that plan.
Both EHP and EHP Plus plans allow college students to visit their student health center for non-routine, non-preventive services. These services will be covered as a specialty visit with a $35 copay. Services may include flu shots, tetanus shots, allergy therapy, and PT/OT/speech therapy, if these are provided at the student health center. It is your responsibility to ensure the service you need can be performed at the college’s student health center for coverage.
There is no out-of-network coverage in either plan except for emergency and urgent care visits. Urgent visits to the college student health centers for an acute illness are treated as such, but may initially be denied as not all college student health centers are contracted with Aetna. If you receive a bill, contact the EHP Customer Service for resolution at 216.986.1050 or 888.246.6648.
We are building the details of the plan offerings and additional information will be coming soon. Please bookmark this site for the most current information. You can also reach out to the following departments with general questions: