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Insurance Plans

Insurance Plan Information

Vanderbilt University Medical Center (VUMC) 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 facility or physician practice.

For accepted insurance plans at our affiliate facilities, visit:


Notice: As of April 1, Vanderbilt Health's hospitals, clinics and affiliated partners will be out of network for patients covered by Medicare Advantage plans offered through Humana and Wellcare of TN. Learn more

Notice: Medicare Advantage Plans Change

As of April 1, Vanderbilt Health's hospitals, clinics and affiliated partners will be out of network for patients covered by Medicare Advantage plans offered through Humana and Wellcare of TN.

For more information, visit:

Aetna

  • Aetna HMO, PPO, POS (Excludes First Health, except Medical Mutual of Ohio)
  • Aetna Behavioral Health
  • Aetna Medicare Advantage
  • Aetna National Advantage (fka Coventry National)
  • Aetna Select VHAN (Premier)
  • Aetna Signature Administrators
  • Aetna TN Preferred
  • Aetna Transplants
  • Aetna Whole Health
  • Meritain Health
  • Meritain Behavioral Health
  • Aetna Specialty Pharmacy

Aetna Better Health – KY Medicaid

  • Aetna Better Health (Kentucky Medicaid. PCP referral required for all adult services)
  • Aetna Better Health Transplants (Kentucky Medicaid. Requires single case agreement)

Ambetter of Tennessee (Commercial Exchange only)

  • Ambetter of Tennessee

Amerigroup

  • Amerigroup Behavioral Health
  • Amerigroup TennCare (Adult providers may require preauthorization.)
  • Amerigroup CoverKids
  • Amerigroup Transplant Medicaid (Tennessee MCO)
  • Amerivantage Medicare Advantage & Dual Special Needs Program (DSNP)

Ascension

  • Ascension Health
  • Ascension Behavioral Health

BlueCross BlueShield

  • BlueCross BlueShield BlueCard (for out-of-state plans with “suitcase”)
  • BlueCross BlueShield of Tennessee Behavioral Health
  • BlueCross BlueShield of Tennessee - Networks P, S (Includes individual exchange plans)
  • BlueCross BlueShield Medicare Advantage PPO
  • BlueCross BlueShield Transplants - BDCT, local BCBST and Medicare Advantage (Medicare Advantage excludes stem cell transplants)
  • BlueCross BlueShield High Performance Network
  • BlueCross BlueShield Specialty Pharmacy
  • Note: Vanderbilt is excluded from Network L & E

BlueCross BlueShield TennCare

  • BCBST CoverKids – Adults > 18 yo patients requires preauthorization
  • BlueCare Adult >18 yo patients requires preauthorization
  • BlueCare Behavioral Health
  • BlueCare & DSNP Transplants (DSNP excludes stem cell transplants
  • TennCare Select Adult >18 yo patients require preauthorization
  • TennCare Select Behavioral Health
  • TennCare Select Transplants
  • Note: Adult and Pediatric Hospitals and VMG are excluded from BlueCare Plus DSNP

Beacon Health Options

  • Beacon Health Options

Center Care

  • Center Care
  • Center Care Behavioral Health

Cigna

  • Cigna HMO, PPO, POS (Includes Local Plus, Open Access and Great West)
  • Cigna Behavioral Health
  • Cigna Connect (Tennessee market Exchange Plan)
  • Cigna Transplants
  • Cigna (aka HealthSpring) Medicare Behavioral Health
  • Cigna (aka HealthSpring) Medicare HMO and PPO (Alliance Direct IPA members are excluded, unless PCP referral obtained)
  • Cigna Medicare PPO & HMO
  • Cigna Transplants through Cigna Lifesource

Deaconess

  • Deaconess Employee Health Benefit Plan

Farm Bureau

  • Farm Bureau Medicare Advantage (effective 1/1/2023)
  • Farm Bureau (Offers individual off-exchange, non-ACA compliant plan thru UMR)

HealthOne Alliance

  • HealthOne Alliance (Alliant Health Plans)

Health Partners

  • Health Partners
  • Health Partners Behavioral Health

Humana

  • Cariten Medicare Advantage HMO, PPO, POS - Pending termination effective 4/1/2023
  • ChoiceCare PPO and NPOS (excludes local POS)
  • Humana (Includes HMO, NPOS and PPO. Excludes local POS)
  • Humana Behavioral Health
  • Humana Medicare Advantage HMO, PPO, POS - Pending termination effective 4/1/2023
  • Humana National Transplant Network (NTN) (includes KY Medicaid)
  • Humana Specialty Pharmacy

Humana Kentucky Medicaid – Healthy Horizons

  • Humana Healthy Horizons KY Medicaid (Adult providers require auth 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
  • Optum VA CCN

Oscar Health

  • Oscar Health Exchange (effective 1/1/2023)

PHCS

  • PHCS (Excludes Multiplan, Megalife, Midwest, any Health Share Ministries such as MediShare, and Physician Only plans, Physician & Ancillary only plans, Reference Based Pricing, and limited benefit plan designs)
  • PHCS Behavioral Health

Prime Health Plan

  • Prime Health PPO
  • Prime Health Behavioral Health

TRICARE

  • TRICARE East Standard and Prime (Humana Military)
  • TRICARE Humana Military Behavioral Health
  • TRICARE Transplants
  • TRICARE West (HealthNet Federal Services)
  • Tricare For Life

UnitedHealthcare

  • Optum Behavioral Health
  • Optum Behavioral Health (TennCare)
  • UnitedHealthcare All Savers
  • UnitedHealthcare (excludes Pacificare)
  • United Core Network
  • United Surest (formerly known as BIND)
  • United Healthcare Heritage (ACO R plans require a referral)
  • UnitedHealthcare Options PPO
  • UnitedHealthcare – United Medical Resources (UMR)
  • UnitedHealthcare The Empire Plan NYSHIP – New York State Health Insurance Program
  • UnitedHealthcare - HCA employees (Authorization required for highest benefit level)
  • UnitedHealthcare NEXUS R (referrals required on some plans, includes ACO plan)
  • United Heritage Choice and Heritage Select Medicare Advantage Plan
  • UnitedHealthcare Medicare Complete/AARP
  • UnitedHealthcare Transplants (Via OPTUM)

UnitedHealthcare Community Care Plan

  • UnitedHealthcare Community Plan TennCare (Adult providers may require prior auth)
  • UnitedHealthcare Community Plan CoverKids
  • UnitedHealthcare Community Plan Transplants (Via OPTUM)
  • UnitedHealthcare Dual Complete® Plans (Medicare/Medicaid)
  • UnitedHealthcare Community Plan of KY – KY Medicaid plan (Adult providers require prior auth)

USA MCO

  • USA MCO
  • USA MCO Behavioral Health
  • USA MCO MEDICARE SELECT

Veterans Affairs (VA)

  • Veterans Affairs (VA)
  • Veterans Affairs (VA) Transplants - for heart, liver and kidney only
  • Veterans Affairs (VA) Community Care Network (via Optum)

WellCare Of Kentucky (KY Medicaid)

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

WellCare Medicare TN (fka Harmony)

  • WellCare (Medicare Advantage) Behavioral Health - Pending termination effective 4/1/2023
  • WellCare Medicare Advantage - Pending termination effective 4/1/2023