Carelon - Missouri | HealthLuminate

Health Plan Overview

Insurance Company	Carelon
State	Missouri
Website	carelon.com
Number of Hospitals in Network	6
Number of Plans Offered	8

Network Hospital Locations

Hospitals in Network (6)

Research Medical CenterCenterpoint Medical CenterLee's Summit Medical CenterBelton Regional Medical CenterLafayette Regional Health CenterCass Regional Medical Center

Available Plans

Not Directly Offered

1 plan

Partnership Service

4 plans

Service Provider

3 plans

Plan Details

Plan Name	Plan Type
NA	Partnership Service
NA	Partnership Service
NA	Partnership Service
NA	Partnership Service
NA	Service Provider
NA	Service Provider
NA	Not Directly Offered
NA	Service Provider

Recent News

2024-05-29

Effective September 1, 2024, Anthem in Missouri (excluding 30 counties in the Kansas City area) will transition to the Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines for medical necessity/clinical appropriateness reviews for requested interventions. This article serves to communicate the adoption of these guidelines, not the implementation of prior authorization requirements.

2024-04-17

Effective October 1, 2024, Carelon Medical Benefits Management, Inc. will expand several programs to perform medical necessity reviews for additional procedures for Anthem members in Missouri (excluding 30 counties in the Kansas City area). This expansion includes clinical appropriateness reviews for procedures across various specialties including cardiology, radiation oncology, radiology, musculoskeletal, sleep, surgical, and other outpatient services.

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