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Insurance Plans

Accepted Insurance Plans

Vanderbilt University Medical Center and Monroe Carell, Jr. Children's Hospital at Vanderbilt are in-network participants in the local and national health insurance plans listed below.

Please note: Vanderbilt may not participate in all products offered by an insurance carrier. We encourage you to contact your insurance company to verify your coverage for care delivered at a Vanderbilt.

A note for those on Medicare: If you are covered by Medicare, you will receive a new Medicare Number and card in the mail to help protect your identity. However, be aware of medical identity theft scams. Medicare will never call and ask you to provide personal or private information to get your new Medicare Number or card. Learn more.

Individual Plans

Open enrollment for health insurance offered in the individual market is Nov. 1, 2020 - Dec. 15, 2020. Several insurance carriers include Vanderbilt in their individual plans.

Aetna

  • Aetna (Excludes First Health, except Medical Mutual of Ohio)
  • Aetna Behavioral Health
  • Aetna Better Health (Kentucky Medicaid. PCP referral required for all adult services.)
  • Aetna Better Health Transplants (Kentucky Medicaid. Requires single case agreement.)
  • Aetna Medicare Advantage
  • Aetna National Advantage (fka Coventry National)
  • Aetna Select VHAN (Premier)
  • Aetna TN Preferred
  • Aetna Transplants
  • Aetna Whole Health
  • Meritain Health
  • Meritain Behavioral Health

Ambetter of Tennessee (Commercial Exchange only)

  • Ambetter of Tennessee

Amerigroup

  • Amerigroup Behavioral Health
  • Amerigroup CoverKids
  • Amerigroup TennCare (Adult providers may require preauthorization.)
  • Amerigroup Transplant Medicaid (Tennessee MCO)
  • Amerivantage Medicare Advantage

Ascension

  • Ascension Health
  • Ascension Behavioral Health

BlueCross BlueShield

  • BlueCross BlueShield BlueCard (For out-of-state plans with “suitcase.” Includes High Performance Network.)
  • BlueCross BlueShield of Tennessee Behavioral Health
  • BlueCross BlueShield of Tennessee – Networks P, S (Includes individual exchange plans)
  • BlueCross BlueShield Transplants (BDCT and local BCBST and Medicare Advantage for solid organs only.)
  • Vanderbilt is excluded from in-network benefits for Network L sold in Memphis

BlueCross BlueShield TennCare

  • BCBST CoverKids (Under age 19. Adults may require preauthorization.)
  • BCBST CoverKids Behavioral Health
  • BCBST CoverKids Transplants
  • BlueCare (Under age 19. Adults may require preauthorization.)
  • BlueCare Behavioral Health
  • BlueCare & DSNP Transplants
  • TennCare Select (Under age 19. Adults may require preauthorization.)
  • TennCare Select Behavioral Health
  • TennCare Select Transplants

Beacon Health Options

  • Beacon Health Options

Center Care

  • Center Care
  • Center Care Behavioral Health

Cigna

  • Cigna (Includes Local Plus, Open Access and Great West)
  • Cigna Behavioral Health
  • Cigna Connect (Expanding from Nashville market to all TN markets beginning 2021.)
  • Cigna (aka HealthSpring) Medicare Behavioral Health
  • Cigna (aka HealthSpring) Medicare (Alliance Direct IPA members are excluded, unless PCP referral obtained.)
  • Cigna SureFit (Pediatric patients only)
  • Cigna Transplants through Cigna Lifesource

Cigna + OSCAR

  • Cigna + OSCAR

Deaconess

  • Deaconess Employee Health Benefit Plan

Farm Bureau

  • Farm Bureau (Offers individual off-exchange, non-ACA compliant plan through UMR.)

HealthOne Alliance

  • HealthOne Alliance (Alliant Health Plans)
  • HealthOne Alliance Behavioral Health

Health Partners

  • Health Partners
  • Health Partners Behavioral Health

Humana

  • Cariten Medicare Advantage
  • Humana (Includes HMO, NPOS and PPO. Excludes local POS.)
  • Humana Behavioral Health
  • Humana Medicare Advantage
  • Humana National Transplant Network (NTN)

Humana Kentucky Medicaid – Healthy Horizons

  • Humana KY Medicaid (Transplants and adults require authorization and may be redirected.)

Integrated Solutions Health Network (ISHN)

  • ISHN CrestPoint

Interlink

  • Interlink Transplants

Lifetrac

  • Lifetrac Transplants

Magellan Healthcare

  • Magellan Behavioral Health

NAMCI

  • NAMCI – North Alabama Managed Care, Inc.

Novanet

  • Novanet
  • Novanet Behavioral Health

Optum

  • Optum Behavioral Health - Commercial
  • Optum Behavioral Health - Tenncare
  • Optum Specialty Pharmacy
  • Optum Spine and Joint Bundle
  • Optum Transplants (fka URN)
  • Optum VA CCN

PHCS

  • PHCS (Excluding Multiplan, Megalife, Midwest, any faith-sharing ministries such as MediShare, physician only plans, physician/ancillary only plans and limited benefit plan designs.)
  • PHCS Behavioral Health

Prime Health Plan

  • Prime Health PPO
  • Prime Health Behavioral Health

TRICARE

  • TRICARE East (Humana Military)
  • TRICARE Humana Military Behavioral Health
  • TRICARE Transplants
  • TRICARE West (HealthNet Federal Services)

UnitedHealthcare

  • Optum Behavioral Health
  • Optum Behavioral Health (TennCare)
  • UnitedHealthcare (Excludes Oxford HMO, Pacificare)
  • United Core Network United Healthcare Heritage (ACO R plans require a referral.)
  • UnitedHealthcare Community Plan (TennCare. Adult providers may require prior authorization.)
  • UnitedHealthcare CoverKids
  • UnitedHealthcare Community Plan Transplants (Via OPTUM)
  • UnitedHealthcare Dual Complete® Plans (Medicare/Medicaid)
  • The Empire Plan NYSHIP – New York State Health Insurance Program
  • UnitedHealthcare – HCA employees (Authorization recommended.)
  • UnitedHealthcare NEXUS (Referrals required on some plans.)
  • UnitedHealthcare® Group Medicare Advantage Plans
  • United Heritage Select Advantage Plan
  • UnitedHealthcare Medicare Complete/AARP
  • UnitedHealthcare Transplants (Via OPTUM)

USA MCO

  • USA MCO
  • USA MCO Behavioral Health

Veterans Affairs (VA)

  • Veterans Affairs (VA)
  • Veterans Affairs (VA) Transplants - for heart and liver only

WellCare Of Kentucky (KY Medicaid)

  • WellCare (PCP referral required for all adult services.)
  • WellCare Transplants (Via OPTUM)

WellCare TN (Formerly Known As Harmony)

  • WellCare (MA) Behavioral Health
  • WellCare Medicare Advantage