MetroHealth Care Plus
Facts and Forms
Care Plus Contact for Providers
Providers can direct questions to the Provider Services line for MetroHealth Care Plus:
Care Plus patients must stay in network. View the entire Provider Network Directory.
Appointments must be scheduled within 30 days of the request.
PCP referrals are required for specialist appointments except for OB/GYN, dental and psychiatry visits.
The patients will present with an identification card and exist in MetroHealth’s electronic medical records system with the Care Plus plan code. View a list of covered services and exclusions.
Care Plus patients have no copays or coinsurances. View a list of covered services and exclusions.
Prescriptions must be written by Care Plus network providers to receive the benefit.
At this time, prescriptions are covered with no copay only when the prescription is filled at a MetroHealth pharmacy. View a list of MetroHealth pharmacy locations.
Admissions must be to MetroHealth.
If no beds are available or if a patient is too unstable for transfer, a MetroHealth physician can approve an initial stay at another hospital. Documentation MUST be processed through the Transfer Center, which can be reached at 216-778-7070.
Skilled Nursing Admissions
Care Plus patients will only be admitted to Prentiss Center and St. Augustine Manor. Other skilled nursing facilities that have a MetroHealth medical director may be added in the future.