Acupuncture Benefit Change
Effective immediately, the acupuncture benefit has been changed. Coverage is now 100% of Allowed Amount after a $35 copay with a maximum of 10 visits per calendar year. Coverage is for specific pain management related diagnoses only.
Cleveland Clinic Children's coming to Akron Ohio
This fall, Cleveland Clinic Children’s will offer pediatric primary and specialty care in a newly renovated space in the Akron Broadway Medical Office Building located at 676 South Broadway Street in Akron, OH. In addition to routine pediatric care, we have pediatric specialists in heart care, digestive disease and much more. Our team of pediatricians, nurses, physical therapists and child life specialists are here to support you.
Until this new location opens, remember we offer primary and specialty services at the following nearby locations to care for your child:
• Akron General Medical Office Building, Tallmadge
• Brunswick Family Health Center
• Cleveland Clinic Children’s Fairlawn
• Cleveland Clinic Children’s Hospital for Rehabilitation
• Cleveland Clinic Children’s Outpatient Center
• Cleveland Clinic Children’s Stow
• Cleveland Clinic Main Campus
• Hudson Express and Outpatient Care
• Medina Medical Office Building
• Mercy Hospital Internal Medicine & Pediatrics, Stark
• Stow-Falls Express & Outpatient Center
• Strongsville Family Health & Surgery Center
To schedule an appointment, call 216.444.KIDS (5437).
Cleveland Clinic Akron General’s New Life Center
Each labor and delivery experience is unique and requires careful thought and personal attention, which is why Akron General has a comprehensive team of caregivers ready to meet the needs of mom and baby. Beginning in November, Cleveland Clinic Children’s neonatologists will staff the NICU at Akron General. Akron General is a Level III Perinatal Center, which means we are prepared for any type of delivery and need for the baby. The unit is being updated with new equipment, and all of these changes will enhance quality and enable us to keep more babies at the same hospital with their mother.
Telephone Visit Coverage
Scheduled and non-scheduled phone calls are not a covered benefit under the Employee Health Plan and can result in a billed service from the provider. For example, members may be billed if they say "Yes" when asked whether it is OK to review laboratory or radiology results during a phone call or phone visit with a provider. Phone calls are considered a self-pay service. However, laboratory and radiology results and notes can be viewed in MyChart at no cost. MyChart offers several options to receive virtual care at no cost to EHP members, including provider messaging and video visits (both scheduled and on demand).
AMA Notice
Leaving medical care against a doctor’s recommendation can be risky. The situation may be considered a “leave AMA,” known as a leave against medical advice (AMA). Patients may have various reasons for doing so, but it’s crucial to understand the potential consequences. Leaving without the provider’s recommendation puts the patient at risk of getting sicker or later having to go back to the hospital. If you leave against medical advice, the health plan does not cover the charges incurred for that stay.
There are many reasons why a patient might do this, such as not understanding the situation, long waits, feeling better, not liking the treatment, family obligations, or concerns about the cost. If you are considering leaving against medical advice, it’s important to have a conversation with your doctor or medical staff to fully understand the risks and consequences. Medical professionals have your best interests in mind, and they can also provide alternative treatment options or address any concerns you may have.
Contact the Employee Health Plan at 216.986.1050, option 1 with any questions.
DME Update:
Compression stocking coverage is 80% and limited to 6 pairs per year. This product can be ordered through an in-network Durable Medical Equipment (DME) provider. As of 1/1/2024 Cleveland Clinic Pharmacies will no longer supply compression stockings. To find a provider, either access the Provider Directory search by your plan-specific network or login to your Aetna Health account.
The Middleburg Heights Pharmacy Is Now Open!
EHP members can now fill prescriptions at the Cleveland Clinic Middleburg Heights Ambulatory Pharmacy. Please see contact information and hours below:
Address:
17840 Bagley Road, Middleburg Heights, OH 44130-3401
Pharmacy is located on the first floor
Hours:
Monday thru Thursday: 8am - 8pm
Friday: 8a - 6p
Closed Saturdays, Sundays and holidays
Contact Information:
Phone: 440.202.2800
Fax: 440.202.2810
Toll Free: 866.650.6337
COVID-19 Public Health Emergency Update:
The COVID-19 Public Health Emergency (PHE) is set to expire on May 11, 2023.
Effective May 12, 2023, the Employee Health Plan (EHP) will cover COVID-19 related services using the same benefit structure applied to other covered diagnoses. Please review your plan specific document below for more details.
Struggling to Pay Your EHP Emergency Department Copay?
$250 can be difficult to pay all at once. Did you know that you can sign up for payroll deduction when your copay is greater than $50. You can pay emergency visit copays, with payroll deduction and remit over 10 pay periods ($25 per pay). Speak to your registrar during your visit about setting up payroll deduction.
You must sign up for payroll deductions during the registration process. To enroll in payroll deduction, you will need to have both your badge number and employee number. Don’t carry your badge with you all the time? Take a picture of the back of your badge, where the numbers are visible. Carry it with you when you need to reference it in the ED and take advantage of payroll deduction.