Conditions We Treat at Tampa Children's ENT

Insurance We Accept at Tampa Children’s ENT

At Tampa Children’s ENT, we understand how important it is for families to know which insurance plans are accepted before visiting our clinic. Our goal is to make pediatric ENT care accessible, seamless, and stress-free for both children and parents.

Below, you will find our accepted insurance plans, important notes about coverage, and how to contact us for any insurance-related questions.

Accepted Insurance Plans

We accept a wide variety of insurance providers to ensure that families have access to high-quality ENT care for their children. The following is a list of major insurance plans we accept:

This list ensures that most families in Tampa and surrounding areas can find coverage for their child’s ENT care. If your insurance is not listed here, please contact our office, and we will help verify coverage or explore alternative options.

Important Notes About Coverage

Understanding the specifics of your insurance plan is crucial for scheduling visits or procedures. Here are some key points to keep in mind:

Prior Authorization or Referrals

Some plans require approval or a referral from your primary care provider (PCP). For example:

Blue Cross Blue Shield requires authorization through the Blue Shield Blue Cross Portal.
United Healthcare Medicaid requires a referral via the UHC Web Portal.
Tricare Prime requires a referral from your PCM.

Surgery Scheduling and Facility Requirements

Coverage for surgical procedures may vary depending on your insurance provider and whether out-of-network benefits apply. Examples include:

Blue Shield Blue Cross Select: Covers all surgery centers.
Blue Shield Blue Cross Anthem: Covers Tampa Bay Surgery Center if out-of-network benefits apply.
Cigna Bay Care: Coverage limited to St. Joseph Children's Hospital.
Aetna Advent Health: Coverage depends on the facility (Pediatric Surgery Center & Tampa Bay Surgery Center for YES Out-of-Network Benefits; HCA Florida Brandon Hospital & St. Joseph Children's Hospital for NO Out-of-Network Benefits).

Limitations and Exceptions

Certain plans may not cover specific services:

No Pediatric Surgery Center coverage for Karin S. Hotchkiss, M.D., M.B.A., F.A.C.S. patients
Cigna Auditory Processing Disorder testing is not covered
Humana Medicaid is not accepted

We recommend contacting your insurance provider prior to your appointment to confirm coverage, co-pays, and any required authorizations to avoid unexpected costs.

Need Assistance? Contact Our Insurance Team

If you have any questions regarding your insurance coverage, required referrals, or prior authorizations, our team is here to assist you. We can help verify your benefits and guide you through the process.

We are committed to helping families navigate insurance and make accessing care as simple as possible.