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 to notify 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, 2022.
Aetna Coventry Medicare Advantage
Aetna Better Health (formerly Illinicare)-MEDICAID ONLY
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 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, National POS)
Evolve Dental- (Meridian and Youthcare patients)
First Health (Aetna Coventry Rental Network)
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
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
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.
*Wellcare is not an in-network plan. Prior Authorizations MUST be obtained in order for Gibson to be paid. If we cannot obtain a prior authorization since we are out of network patients will be responsible for the out-of-network balance or be set to self-pay. Please note we are working on this contract currently to be in-network but are still in the beginning stages.
*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, Blue Cross Blue Shield HMO, Centene-Ambetter, Cigna, CountyCare Health Plan, Health Alliance Simplete Tier 1, Healthlink, Humana HMO, Humana Medicare, Liberty HealthShare, NextLevel Health, United Healthcare Behavioral Health, United Healthcare-Optum VACCN, United Healthcare-Medicare Advantage.
***Disclaimer: This exclusion list is not comprehensive.