Using Ambetter Buckeye Insurance at Monarch Ideal Care in Fairlawn & Akron
!Important Eligibility Notice!
Monarch Ideal Care accepts Ambetter Buckeye Marketplace (Exchange) plans only.
Ambetter Buckeye Medicaid and Medicare plans are not eligible for insurance-based or concierge care at our practice.
Please confirm your plan type before scheduling.
Confirming Marketplace Eligibility Before Scheduling
Patients must verify that:
Their Ambetter Buckeye plan was purchased through the Health Insurance Marketplace
Dr Leslee Mcelrath is an approved provider within that Marketplace plan
The plan is not a Medicaid or Medicare product
Contact Ambetter Buckeye directly to confirm eligibility.
How Ambetter Buckeye Marketplace Visits Work
Visits are in-person only
Appointments are scheduled during weekday business hours via text with our Virtual Assistant
Claims are submitted after your visit
Final patient responsibility is determined by your Molina Marketplace plan
Understanding Your Insurance Costs (Important)
Many billing concerns come from misunderstanding how insurance works. Below is a simple breakdown:
Copay
A fixed amount you may owe at the time of your visit (for example, $25 or $40), depending on your plan. At Monarch Ideal Care we charge a standard $30 to schedule your appointment to cover the copay amount.
Deductible
The amount you must pay out-of-pocket each year before insurance begins paying for covered services. This number resets to $0 each January 1st.
Coinsurance
After your deductible is met, some plans require you to pay a percentage of the visit cost (for example, 20%), while insurance covers the rest.
Out-of-Pocket Maximum
The maximum amount you'll pay in a year for covered services. Once reached, insurance typically covers 100% of eligible costs for the remainder of the year.
If you're unsure how these apply to your plan, your insurance company is the best source for clarification.
Billing & Payment Policy (Please Review)
After your insurance claim has fully processed:
Any remaining balance is your responsibility
A statement will be issued for the amount owned
Practice policy:
Once a balance has been billed and insurance has completed processing, future appointments cannot be scheduled until the balance is paid.
This policy helps prevent unexpected of accumulating balances and ensures transparency for all patients.
If Your Plan Is Not Eligible
If your Ambetter Buckeye plan is Medicaid or Medicare, you may still receive care through:
Direct Primary Care — available regardless of insurance type
Concierge Care — for patients with qualifying private insurance
Frequently Asked Questions
I have Ambetter Buckeye through Medicaid — can I schedule an insurance visit?
No. Only Ambetter Buckeye Marketplace plans are eligible. Medicaid and Medicare plans are not currently accepted.
What if I'm not sure which Ambetter Buckeye plan I have?
Contact Ambetter Buckeye directly to confirm whether your plan is a Marketplace plan before scheduling the meet and greet.
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