How To Get the Care You Deserve, Covered by Insurance
Jon Costin, MHA
May 12, 2026
How Do I Understand My AndHealth Care Costs?
Most people managing a chronic condition have had this experience: you finally get in to see a specialist, they order a test, and six weeks later a bill shows up that you never saw coming. No one told you what it would cost or asked if you could afford it. And now that bill is your problem.
We think that’s wrong. And we think it’s bad medicine.
At AndHealth, we believe whole person care includes financial health as well as your physical health. What good would we be if the cost of your care was the thing raising your blood pressure, causing you undue stress, or sending you into a flare? Your AndHealth care team will talk about cost of a test before we order, not after.
And we understand that every visit has a real cost beyond the copay: time off work, gas, childcare, time away from your family. So we try to bring care to you, through more convenient options for care, such as telehealth appointments, lab work drawn in your home from a mobile phlebotomist, and medication shipped to your home. Because getting better shouldn’t mean upending your life to do it.
Here’s what the cost of AndHealth care actually looks like, depending on your situation.
What Insurance Plans Does AndHealth Accept?
We are in-network with Medicaid, Medicare, TRICARE, and most commercial health plans—including PPO, HMO, EPO, and POS plans—in Ohio and Indiana. That includes:
- Medicaid (Ohio and Indiana): AndHealth was built with Medicaid patients in mind, and we’re proud to be a place where all Medicaid members can access the same high-quality specialty care as anyone else.
- Medicare and Medicare Advantage (Ohio and Indiana): Most Medicare and Medicare Advantage plans are accepted. Costs vary by plan type, and our team will walk you through what to expect before your first appointment.
- Employer and marketplace plans: If you have coverage through your job or purchased through the ACA Marketplace, there’s a good chance we’re already in your network.
- TRICARE: Active duty and veteran military families are covered.
- Uninsured: Through our partnerships with Community Health Centers, we can help you schedule a provider appointment even if you don’t have insurance right now. A sliding fee scale is available, and our patient care navigators will work with you to find options for care and assistance programs for housing, transportation, groceries, and utilities.
Don’t see your plan listed? Call us at 614-526-4551, we may still be able to help.
What Is My Estimated Cost of Care For AndHealth Services?
Your costs depend on your health plan, but here’s a straightforward breakdown by insurance type. Note that some services are provided at no cost regardless of your plan because we believe those services are part of what good care looks like.
Note: All information is subject to the specific details of your care plan that’s co-created with your specialist, and your current health plan and plan year.
If you have Medicaid
Medicaid patients receive comprehensive care with no copay across the entire care team.
| Service | Your Cost |
|---|---|
| Specialist visit (neurologist, rheumatologist, dermatologist) | No copay |
| Clinical pharmacist visit | No copay |
| Health coach | No copay |
| Patient care navigator | No copay |
| Prescriptions, lab work, imaging (X-ray, MRI) | No cost |
| Nutrition support, sleep tracking, health coaching programs | No cost |
If you have Medicare or Medicare Advantage
Medicare costs vary by plan type, but here’s what most patients can expect:
| Service | Your Cost |
|---|---|
| Specialist visit (neurologist, rheumatologist, dermatologist) | Specialist copay (varies by plan) |
| Clinical pharmacist visit | Primary care / office copay (varies by plan) |
| Health coach | No copay |
| Patient care navigator | No copay |
| Medications | Per your health plan* |
| Lab work, imaging (X-ray, MRI) | Per your health plan |
| Nutrition support, health coaching programs | No cost |
*Financial assistance from AndHealth may be available after secondary insurance and drug coupons are applied
If you have an employer or marketplace plan (commercial insurance)
| Service | Your Cost |
|---|---|
| Specialist visit (neurologist, rheumatologist, dermatologist) | Specialist copay (varies by plan type—HMO, PPO, HDHP) |
| Clinical pharmacist visit | Primary care / office copay (varies by plan) |
| Health coach | No copay |
| Patient care navigator | No copay |
| Medications | Per your health plan |
| Lab work, imaging (X-ray, MRI) | Per your health plan |
| Nutrition support, health coaching programs | No cost |
If you are uninsured
| Service | Your Cost |
|---|---|
| Provider visits | Sliding fee scale through our CHC partners |
| Patient navigator support | Included—your navigator will work with you to find options |
| Assistance programs | Your navigator can also help you find qualified programs |
Based on My Health Plan, How Will AndHealth Help Keep My Care Affordable?
We understand that chronic condition management is expensive for patients and their families. That’s why helping you navigate the cost of care isn’t an afterthought at AndHealth—it’s part of your care team’s job.
- Your Patient Care Navigator Your navigator is your guide through the insurance and financial side of your care. They’ll work with you to verify coverage, help with prior authorizations, coordinate provider scheduling, and assist with transportation if needed. If you’re uninsured or underinsured, they’ll connect you with sliding fee scale options and assistance programs, so that your health plan never becomes a barrier to getting started.
- Your Clinical Pharmacist Specialty medications for chronic conditions—including biologics, disease-modifying therapies, and infused treatments—can be among the most expensive parts of care. Your AndHealth clinical pharmacist is specifically focused on making sure your medications are as affordable as possible. They’ll coordinate with drug manufacturers, apply copay assistance programs, and work through the details of your insurance plan so you’re not paying more than you have to. Free home delivery is included.
- For Medicare patients specifically Medicare coverage can be complicated, especially with Medicare Advantage plans that have different cost structures depending on whether you have an HMO, PPO, or other plan type. Your AndHealth team will review your specific plan with you upfront—so you know what to expect before your first appointment, not after.
The bottom line Your care team will always help you understand the cost of treatment and work to make sure your out-of-pocket costs are as low as possible—for every service, every medication, and every step of your care plan.
Ready to Find Out What AndHealth Will Cost For You Specifically?
The best way to get a clear picture of your costs is to start with a new patient call. We’ll review your insurance, answer all your questions, and make sure there are no surprises before your first appointment.
About the Author
Jon Costin, MHA, is a Senior Director of Operations at AndHealth.
Over the course of his career, he’s worked across almost every corner of the healthcare system, from standalone specialty clinics to large tertiary hospitals, in ambulatory and inpatient settings alike.
That breadth gave him a firsthand understanding of how hard the system can be to navigate, and how much that difficulty costs patients. He came to AndHealth because he believes everyone deserves access to high-quality specialty care, regardless of where they live, what insurance they have, or how complicated their condition is.
AndHealth provides whole-person specialty care—including neurology, rheumatology, and dermatology—through Community Health Centers in Ohio and Indiana. We are in-network with Medicaid, Medicare, TRICARE, and most commercial health plans. Learn more at andhealth.com.
This website is for informational purposes only and does not provide medical advice, diagnosis, or treatment. Use of this site does not establish a doctor-patient relationship. Always seek advice from a qualified healthcare provider regarding medical conditions or new regimens. Never ignore professional medical advice because of something you read here. The owner disclaims all liability for the accuracy of this content or actions taken based upon it. If you are experiencing a medical emergency, call 911 or your doctor immediately.