Provider Network
The EHP network includes Cleveland Clinic employed physicians and facilities as well as other local contracted providers. It is your responsibility to verify your provider's participation each time services are obtained. To locate a provider, click here. Note: You must first register with Aetna to view your plan specific network.
TIER 1 | TIER 2 | |
Network | Cleveland Clinic Quality Alliance (QA) Florida Clinically Integrated (CIN)** | Aetna Select Open Access |
Deductible | 0 | $500 Single / $1,500 Family |
Coverage | 100% after applicable co-pay or co-insurance | 70% after deductible and applicable co-pay or co-insurance |
Emergency/ Urgent Care | 100% coverage after applicable co-pay ($50 for Urgent Care / $250 for Emergency*) | 100% coverage after applicable co-pay ($50 for Urgent Care / $250 for Emergency*) |
Cleveland Clinic employees should go directly to the third-party administrator (TPA) to resolve any claims payment issues. The Cleveland Clinic EHP Third Party Administrator (TPA) is Aetna. The Aetna concierge customer service department can be reached by calling 1.833.414.2331. You can access your health benefit information by registering at Aetna.comor download the free Aetna mobile app for more convenient access to your benefits. Click here for detailed instructions. If your issue is not resolved to your satisfaction after calling the TPA directly, please call the Cleveland Clinic Customer Service Unit at 216.986.1050, option 1.
**Florida Region Network Additions:
Tier 1 is supplemented with Aetna providers in the following specialties within the seven counties surrounding our Florida hospitals: Allergy, Behavioral Health, Chiropractic, Dermatology, Endocrinology, Neurology, Nutritionist, OB-GYN/Obstetrics, Ophthalmology, Otolaryngology (ENT), Oral Surgery, Pain Management, Pediatrics and Podiatry. The seven counties include Brevard, Indian River, St. Lucie, Martin, Palm Beach, Broward and Miami-Dade. We have also supplemented additional non-Cleveland Clinic hospitals in support of the admitting privileges of the above provider specialties. They are:
Baptist Hospital, Broward Health Medical Center, HCA Florida Hospitals, HCA Florida Lawnwood Hospital, Holmes Regional Medical Center Aging Services, Holmes Regional Medical Center OP Pain Infusion and Wound, Holmes Regional Medical Center, Jupiter Medical Center, Memorial Hospital, Memorial Regional Hospital, Palm Bay Community Hospital, St. Mary’s Medical Center, University of Miami Hospital and Clinics.
The Tier 1 network has been supplemented with Aetna providers in both Florida and Ohio for the specialty of Behavioral Health.
It is the member’s responsibility to verify a provider’s network participation prior to receiving services. You can search providers in the Martin Hospital Under 65 Retiree provider directory which can be accessed via our website at employeehealthplan.clevelandclinic.org or log into your Aetna Health account.