Prior to receiving services, all patients are encouraged to verify their benefits with their plan administrator by calling the contact information phone number listed on their health insurance card. Patients are responsible for any out-of-network expenses for services rendered at Gibson Area Hospital. Gibson Area Hospital is not responsible for notifying patients when network affiliations are changed.
Gibson Area Hospital is a preferred provider of the health plans of many different insurance companies and health networks throughout our service area. A sample listing of the insurance companies and health networks that are accepted by Gibson Area Hospital is listed below. Gibson Area Hospital does not participate in every product a health plan offers. Many insurance companies may be included in the plans listed below. Gibson Area Hospital also contracts directly with some employers. Please contact your employer or insurance carrier if you have questions about your coverage.
Following are the health insurance companies we now accept as of January 01, 2023.
- Aetna Coventry
- Aetna Coventry Medicare Advantage
- Aetna Better Health (formerly Illinicare)-MEDICAID ONLY
- Avesis
- Beech Street
- Blue Cross Blue Shield – PPO + Blue Choice Preferred
- Blue Cross Blue Shield- Medicare Advantage Flex PPO (only in-network plan for MA with BCBS)
-
Blue Cross Blue Shield of Illinois Blue Distinction Center Designation for Quality in Knee and Hip Replacement Surgeries. Details and information here: Blue Distinction Center Designation Information
- Blue Cross Community Health Plans – MEDICAID ONLY
- Centene – Meridian Medicaid
- Centene – Meridian Complete (MMAI)
- Centene – WellCare Medicare Advantage
- Centene – Youthcare
- Community Partners Health Plans (CPHP network covers Humana PPO, Choice Care Network PPO & POS, and National POS)
- Consociate Health- Advanced Medical Transport, Illinois Farm Business Management, United Prairie ONLY
- DentaQuest
- Evolve Dental- (Meridian and Youthcare patients)
- First Health (Aetna Coventry Rental Network)
- Health Alliance
- Health Alliance Medicare Advantage
- Health Alliance Simplete Tier 2 and Tier 3 ONLY
- HFN, Inc. – all products including HMO, self-funded & workers comp
- Humana Military-Formerly TriCare-*See Below
- Integrated Health Plan
- Interplan Health Group
- Medicaid
- Medicare – In addition to regular Medicare, all Medicare Supplement Plans F & G are accepted.
- Meridian Health Plan **Including YouthCare of Illinois** – MEDICAID ONLY
- Molina Healthcare – Medicaid + Dual Options
- MultiPlan/PHCS – excludes HMOs, Medicare Plans & Consumer Savings Cards
- Mutual Medical-City of Clinton employees only
- NPPN (National Preferred Provider Network)
- Prime Health Services Inc.
- Provider Network of America (PNOA)
- SIHO Network, LLC
- Quanex Employees
- Three Rivers
- UMR (UHC Rental Network)
- UnitedHealthcare – **excludes Behavioral Health, VACCN, and Medicare Advantage
**GAH is only in-network for BCBSIL PPO plans. We are not in-network for out-of-state plans or national plans such as Anthem. Some plans allow us to submit claims to local BCBS. However please note you could pay out-of-network costs.
*TRICARE East --Humana Military – We are not in-network. However, we can accept patients as certified members of these insurances. Will apply to in-network benefits. MUST have a prior auth.
*Regarding Medicare Advantage (MA) products not listed above; most MA plans do offer out-of-network benefits for many services—benefits must be confirmed/authorized prior to service.
*Behavioral Health benefits may be handled by a third-party administrator, or even excluded, from some of the plans listed above—benefits must be confirmed/authorized prior to service.
*We are OUT OF NETWORK with the following companies and/or listed products:
Aetna Better Health MMAI Plan, AMBETTER-MMAI, Blue Cross Blue Shield HMO, BCBS MA or MMAI, BCBS Out-of-State Plans, Cigna, CountyCare Health Plan, Health Alliance Simplete Tier 1, Healthlink, Humana HMO, Humana Medicare Advantage, Humana MMAI, Liberty HealthShare, NextLevel Health, United Healthcare Behavioral Health, United Healthcare-Optum VACCN, United Healthcare-Medicare Advantage.
***Disclaimer: This exclusion list is not comprehensive.
