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Does your insurance plan
include Children's Mercy?

Navigating your family's health insurance plan coverage can be complicated, especially with all of the options available in the health insurance exchanges. But one thing is simple. If you have a child, make sure your plan includes Children's Mercy.

Covered services and programs vary by insurance plan and employer. It is important to check with your insurance plan to ensure your specific benefits include coverage for services at Children's Mercy. Should you have questions regarding your insurance benefits and coverage, please contact your insurance carrier directly.


  • Aetna CareLink

  • BlueKC BlueSelect Plus

  • BlueKC Preferred Care Blue

  • BlueKC Blue Choice

  • BCBS Kansas Solutions / Blue Care

  • Cigna Connect

  • Medica - Medica Connect (utilizing ProviDRs Care Network)

  • Medica - Medica with MU Health Care (referral required)

  • Medica - Select by Medica


  • Ambetter from Home State Health (Missouri) 

  • Ambetter from Sunflower Health Plan (Kansas)

  • Balance by Medica (offered in SW MO and St. Louis)

  • Blue KC BlueSelect

  • Cox Health (offered in SW MO only)

  • Oscar Health

  • United Healthcare

  • US Health and Life



  • Aetna

  • American Healthcare Alliance

  • Anthem BCBS of Missouri (utilizing BlueKC network)

  • BlueKC

    • Blue Access (Out-of-Network)
    • BlueCard PPO (plans with PPO suitcase on ID card)
    • BlueSelect (Out-of-Network)
    • BlueSelect Plus
    • High Performance Network
    • Freedom
    • Freedom Network Select
    • Preferred Care
    • Preferred Care Blue
    • Preferred Health Professionals

  • BCBS of Kansas BlueChoice Solutions

  • Cigna (including Great-West Healthcare)

    • Cigna + Oscar
    • Cigna Plus
    • Cigna SureFit
    • Connect
    • HealthPartners
    • LocalPlus or LocalPlusIN
    • MVP Health Care
    • Network Open Access
    • Open Access Plus
    • PriorityHealth
    • Tufts Health Plan

  • CoxHealth Network

  • CoxHealth Plans (utilizing First Health Network)

  • First Health Network

  • HealthLink HMO

  • HealthLink Open Access (OA)

  • HealthLink PPO (utilizing Freedom Network)

  • Health Midwest Comprehensive Care (HMCC) Well Care

  • Humana

  • Medica

    • Balance by Medica (Out-of-Network)
    • Medica Connect (utilizing ProviDRs Care network)
    • Medica with MU Health Care (referral required)
    • Select by Medica

  • Mercy Health Springfield Communities

  • MultiPlan (excluding all health and/or cost sharing ministries)

  • National Preferred Provider Network

  • Orscheln Industries (utilizing HealthSCOPE TPA)

  • PHCS (excluding all health and/or cost sharing ministries)

  • ProviDRs Care (formerly WPPA)

  • QuikTrip

  • United Healthcare (UHC)

    • All Savers
    • Bind On-Demand (limited benefit coverage)
    • Custom Network Plan (Out-of-Network)
    • Deere Premier (Out-of-Network)
    • GEHA
    • UHC Core Essential
    • UHC Choice & Choice Plus
    • UHC Navigate
    • UHC NexusACO
    • UHC Options
    • UHC Select
    • UMR

  • USA Managed Care Organization

Government Insurance Plans

If you have Medicaid coverage and do not live in Kansas or Missouri, please contact your State Medicaid Agency or Health Plan to verify that Children’s Mercy Kansas City is authorized to provide care to your child prior to seeking services. Many States have special requirements that need to be followed before seeking services from an out of State provider and if these are not followed you may not have coverage and be financially responsible for the care you receive at Children’s Mercy Kansas City. The phone number to call for this information should be located on your benefit card that is provided by your State Medicaid Agency or Health Plan when you become eligible for Medicaid coverage.

Federal Plans

  • TriCare/Health Net Federal Services

State Medicaid Plans

  • Arkansas Medicaid

  • Kansas Medicaid

  • Missouri Medicaid

  • Oklahoma Medicaid (referral required)

Managed Medicaid Plans - Kansas

  • Aetna Better Health

    • SkyGen USA Dental
    • SkyGen USA Vision

  • Sunflower Health Plan

  • United Healthcare Community Plan

Managed Medicaid Plans - Missouri

  • Healthy Blue

  • Home State Health

  • United Healthcare Community Plan

Specialty Networks

Behavioral Health (Outpatient)

  • Cenpatico

  • Evernorth Behavioral Health (formerly Cigna Behavioral Health)

  • MHNet Behavioral Health

  • New Directions Behavioral Health

  • Optum / United Behavioral Health

Specialty Centers of Excellence - Transplant Networks

  • Aetna Institutes of Excellence

  • Blue Distinction Centers (BDC) for Transplant

  • Cigna LifeSOURCE Transplant Network

  • Humana National Transplant Network

  • Optum Pediatric Transplant Centers of Excellence Network


  • Delta Dental

  • DentaQuest

  • MetLife

  • SkyGen USA (formerly Scion Dental)


  • Envolve Vision/Opticare

  • SkyGen USA (formerly Ocular Benefits)

  • Vision Service Plan (VSP)

A narrow network is a type of health plan that requires members to receive care in their preferred, narrow network of a select group of doctors, hospitals, outpatient facilities, laboratories, etc.

  • Aetna I-35 Preferred

    • Adult Health System Network: AdventHealth Shawnee Mission, KU Medical Center, Liberty Hospital, HCA MidWest Health, North Kansas City Hospital, Olathe Health, University Health

  • Aetna Connected

    • Adult Health System Network: AdventHealth Shawnee Mission, KU Medical Center, Liberty Hospital, HCA MidWest Health, North Kansas City Hospital, Olathe Health, University Health

  • BlueKC High Performance Network

    • Adult Health System Network: Saint Luke’s Health System

  • Cigna Sure Fit

    • Adult Health System Network: HCA MidWest Health, North Kansas City Hospital

  •  Cigna Local Plus

    • Adult Health System Network: HCA MidWest Health, North Kansas City Hospital

  • UHC Core Essential

    • Adult Health System Network: Saint Luke’s Health System

See the out-of-pocket cost comparison to paying through an insurance plan.

What steps can I take if I have an out-of-network plan?


  • Ambetter from HomeState Health Plan (MO)

  • Ambetter from Sunflower Health Plan (KS)

  • Anthem Pathway/Pathway X (KS locations only)

  • Aspen STM (All Hospital/Facility Services)

  • Balance by Medica

  • Blue Access (BCBS of Kansas City)

  • Blue Select (BCBS of Kansas City)

  • Cox Health EPO

  • Custom Network Plans (Administered by United Healthcare)

    • Custom Network Plan
    • Deere Premier

  • HealthChoice of Oklahoma 

  • Kaiser Permanente

  • LifeShield STM (All Hospital/Facility Services)

  • Medicaid Arkansas CareSource PASSE

  • Medicaid Arkansas Empower PASSE

  • Medicaid Arkansas Total Care PASSE

  • Medicaid Arkansas Summit PASSE

  • Mercy Anthem Alliance EPO (Anthem BCBS) 

  • Oscar Health

  • PHCS Practitioners Only (All Hospital/Facility Services)

  • Preferred CommunityChoice

  • Walmart / Mercy: Arkansas Local Plan & Southwest Missouri Local Plan

  • All Medicaid and managed Medicaid plans outside of the states of Arkansas, Kansas, Missouri and Oklahoma unless mentioned above as in-network.

Behavioral Health

  • Beacon Health Options (formerly Value Options)

  • Magellan Healthcare

  • Mercy Managed Behavioral Health


  • Envolve Dental

Home Care

  • Humana


  • ETS (formerly LifeTrac)

Transplant Network

  • TheraMatrix (BCBS of Michigan)


  • EyeMed

  • March Vision Care



  • Bind On-Demand Health Insurance

  • PHCS Limited Benefit Plan

  • Prime Healthcare (Anthem Blue Cross)

Q: I've heard a lot about health care insurance changes. How do they affect me?

As part of the Affordable Care Act, all Americans must have health insurance as of 2014.

Q: What are the options for purchasing health insurance for my child?

Options include:

Q: What is a Health Insurance Exchange?

The Health Insurance Exchange at was designed as a one-stop shop to find, compare and buy private health insurance options.

Neither Missouri nor Kansas have their own state exchange, so you'll find your options on the federal Health Insurance Exchange at

Q: When can I enroll/when is open enrollment for insurance coverage on the Health Insurance Exchange ( Can I enroll outside open enrollment time period?

Open enrollment (enrollment for anyone) is Nov. 1 – Dec. 15 annually, but you may enroll year-round if:

  • You qualify for or are renewing Medicaid (MO HealthNet or KanCare) coverage.
  • You are an American Indian/Alaska Native who is an enrolled member of a federally recognized Tribe or Alaska Native Corporation.
  • You are enrolling in the Small Business Health Options Program (SHOP).
  • You experience certain life events like:
    • Getting married
    • Having a child
    • Moving to a new area
    • Losing health coverage

These may qualify you for a special enrollment period. You can see if you qualify for any of these at

More details and updated dates available at

Q: My child is a patient at Children's Mercy, or I want my child to be seen at Children's Mercy in the future. What do I need to know about my health insurance coverage?

When choosing any plan, even a plan purchased through your employer or outside of the Exchange, you should always make sure Children's Mercy is an in-network provider so that your child can continue care or receive care at Children's Mercy in the future. 

Those plans that exclude essential providers like Children's Mercy have two deductibles: One for services at in-network providers and one for services at out-of-network providers. Out-of-pocket costs could be higher if your child visits a provider who is out-of-network with your insurance plan.

Q: What should I consider when comparing health insurance?

When comparing, consider these things:

  • What is covered?
  • What is my monthly cost?
  • What is my deductible?
  • What is my coinsurance and copay?
  • Which providers can I see with this plan?
  • Annual out-of-pocket maximum for in-network services and annual out-of-pocket maximum for out-of-network services?

Q: How do I know or how do I make sure Children's Mercy is included in my plan?

You can always contact your insurance provider. You can also contact any number of navigators, whose services help ensure your family has adequate coverage. See list here.

Q: What can I do if my insurance plan doesn't cover Children's Mercy, I was denied coverage or I am unhappy with my insurance?

You are the best advocate for your child. We encourage you to call the Department of Insurance (DOI) with concerns; the providers your insurance recommends; the timeframe for getting a response; or anything else about your health insurance. The DOI oversees the insurance industry and protects you as an insurance consumer.

Q: Why is Children's Mercy not a provider on all plans?

We continue to negotiate with insurance companies. Despite our best efforts, we have found that some companies have chosen not to contract with us.

Our hope is that all health insurance plans will cover Children's Mercy, especially since many services are not provided elsewhere in the region, so we can serve your child and all children in Kansas and Missouri.

Q: Is there anything I can do to help ensure Children's Mercy is included in health plans?

Contact your employer or insurance provider and tell them you think Children's Mercy is an essential provider for any health plan network.

Q: I'm an adult patient at Children's Mercy. How do I get coverage?

Please contact our financial counselors at (816) 234-3567  and they can help.

Q: What if my child is seen at Children's Mercy and does not have insurance?

Please contact our financial counselors at (816) 234-3567 and they can help.

Why choose Children's Mercy?

Children's Mercy is ranked as one of America's best pediatric hospitals by U.S. News and World Report. With our world-renowned Genome Center, the region's only Level IV Neonatal Intensive Care Unit (NICU) and more than 760 pediatric specialists in 40 specialties, we're the region's only hospital completely focused on treating kids — all in an environment specifically designed for the way kids need to be treated. As the region's only children's hospital, Children's Mercy is an essential provider to the community. There are many reasons our families come here, community providers refer to Children's Mercy and insurance plans cover our services including:

  • 90% of all pediatric specialists (physicians only) in the Kansas City metro are at Children's Mercy.
  • Children's Mercy has 40 areas of specialties, 19 of which are only offered in the Kansas City metro by pediatric subspecialists at Children's Mercy.
  • U.S. News and World Report ranks Children's Mercy as one of the best children's hospitals, ranking us in 10 specialties: Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Gastroenterology & GI Surgery, Neonatology, Nephrology, Neurology & Neurosurgery, Orthopedics, Pulmonology, and Urology.
  • Children's Mercy received nursing's highest honor, Magnet Designation, from the American Nurses Credentialing Center for the fifth time in 2020.