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Health Insurance

Nicklaus Children's Hospital, formerly Miami Children's Hospital, is a preferred pediatric provider for most major South Florida health insurance plans. For parents, this means that your health insurance program is likely to cover the specialized pediatric care provided by Nicklaus Children's Hospital - the only pediatric hospital in South Florida dedicated exclusively to children.

Nicklaus Children's Hospital is committed to providing our pediatric patients with the highest level of care in cooperation with today's managed care environment. Our Managed Care department works closely with HMOs, PPOs and other health plans to track patient care and monitor outcomes.

Below we have outlined the most common health plans Nicklaus Children’s Hospital participate with, alongside each insurance's respective authorization requirements for the most common diagnostic studies. Authorization requirements vary by each plan/group and the below should be used as a guide. Please contact your health plan directly to verify if your insurance plan is participating with Nicklaus Children’s and to verify authorization requirements as some insurance plans utilize narrow networks which may exclude our facility. The Authorization Unit can also be contacted at 786-624-3022 for further clarification.

(Note: participation in these plans is not a guarantee of payment or coverage).

Insurance Provider HMO PPO Federal Exchange Medicaid Healthy Kids International
Aetna U.S. Healthcare, Inc. HMO PPO       Intnl.
Amerigroup Florida, Inc.       Medicaid Healthy Kids  
AvMed Health Plan HMO PPO        
Best Doctors, Inc.           Intnl.
Better Health       Medicaid    
Blue Cross and Blue Shield of Florida, Inc.         Healthy Kids  
Blue Cross and Blue Shield
of Florida Health Options, Inc.
HMO          
Blue Cross and Blue Shield
Network Blue
  PPO        
Blue Cross and Blue Shield
Blue Options
  PPO Federal Exchange      

Blue Cross and Blue Shield
Federal plan

  PPO        
Cigna Healthcare HMO PPO Federal Exchange     Intnl.
CMS Network       Medicaid Healthy Kids  
Coventry Health Care HMO PPO   Medicaid Healthy Kids Intnl.
Health Ease, Inc. of Florida       Medicaid    
Humana HMO PPO   Medicaid    
Molina Healthcare of Florida, Inc.       Medicaid    
Multiplan HMO PPO        
Neighborhood Health
Partnership, Inc. [NHP]
HMO PPO        
Preferred Medical Plan HMO          
Prestige Health Choice, LLC       Medicaid    
Simply Healthcare Plans, Inc.       Medicaid    
Staywell       Medicaid Healthy Kids  
Sunshine State Health Plan       Medicaid Healthy Kids  
Tricare            
UMR HMO PPO        
United Healthcare of Florida, Inc. HMO PPO Federal Exchange Medicaid Healthy Kids Intnl.
Virgin Islands Medicaid Program       Medicaid    

 

***Please note that some non-employed physicians and credentialed medical staff members of Nicklaus Children's Hospital may not accept all of the health plans listed above.


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