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Is ProMedica in your plan? Get a free check.
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How the check works: a licensed agent checks ProMedica, and any doctors you name, against every 2026 marketplace plan filed in your county, then sends you the plans that include them and the date it was checked. It costs nothing, and you only get a call if you ask for one.
- Your ZIP code
- Who to check — ProMedica is filled in
- Your answer, usually the same day
Open Enrollment for 2027 runs November 1 to January 15: choose by December 15 for coverage from January 1. CareSource is leaving Ohio’s marketplace for 2027. If your plan is from CareSource, it ends December 31, and the plan that replaces it may not include ProMedica. A licensed agent will check the 2027 plans for you before you choose.
ProMedica runs 2 hospitals in Ohio, in Defiance, Toledo. Whether a marketplace plan covers any one of them depends on the individual plan, not on the carrier's name, and it can change during the year. Here is what is actually knowable, and how to settle it for your own plan.
Insurance at ProMedica: the short answer
These 7 insurers sell 2027 marketplace plans in Defiance and Lucas counties: Ambetter from Buckeye Health Plan, Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., MedMutual, Oscar Health Insurance, UnitedHealthcare and AmeriHealth Caritas Next.
That is not a list of plans ProMedica accepts. Hospitals contract with individual plans, not whole insurers, so the same insurer can sell one plan that includes ProMedica and another that doesn’t. The answer that counts is a check of your exact plan, dated. Get my free hospital check ↑
Searching for MetLife, Delta Dental or Renaissance? Those are dental insurers: dental plans cover teeth, not hospital care. If you want dental coverage too, see dental insurance for individuals.
Where ProMedica is
2 facilities, taken from the CMS Hospital General Information file, updated 22 July 2026. Listing a hospital is not a statement about which plans contract with it — that is decided plan by plan.
| Hospital | City | County | Emergency room | CMS star rating | Type | Ownership |
|---|---|---|---|---|---|---|
| ProMedica Defiance Regional Hospital | Defiance | Defiance County | Yes | 5 of 5 | Critical access | Non-profit |
| ProMedica Toledo Hospital | Toledo | Lucas County | Yes | 4 of 5 | Acute care | Non-profit |
CMS star rating is the federal overall hospital quality rating, 1 to 5, from the same July 2026 CMS file. Small rural (critical access) hospitals often have too few reported measures to be rated.
Why no page can promise your plan covers ProMedica
Hospital networks are set plan by plan and renegotiated during the year. Two plans from the same insurer, at similar prices, can differ on whether a hospital is in network. Nothing in the public CMS files records hospital contracts, so any page listing "insurers ProMedica accepts" is describing one plan on one day, and not saying which.
What is knowable is the shape of the market: 7 insurers file 221 plans across the 2 counties below, and every plan filed in Defiance County for 2027 is a restricted network — HMO — so out-of-network care is generally limited to emergencies.
Three checks settle it for your own plan: the insurer’s own provider directory for the exact plan name, the hospital’s billing office (ask about the plan, not the carrier), and the date you checked, because the answer can change mid-year.
The 2027 marketplace where ProMedica sits
Filed rates for plan year 2027, before any premium tax credit. Benchmark Silver is the second-lowest-cost Silver plan for a 40-year-old, the plan credits are calculated against.
| County | Insurers filing | Plans filed | PPO sold | Benchmark Silver, age 40 | Family of 4, per month |
|---|---|---|---|---|---|
| Defiance County | 6 | 106 | No | $627 | $2,006 |
| Lucas County | 7 | 115 | No | $626 | $2,003 |
In Defiance County the insurers filing are Ambetter from Buckeye Health Plan, Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., MedMutual, Oscar Health Insurance, UnitedHealthcare. No PPO is sold here.
How many providers each insurer lists in Defiance County
Every insurer selling marketplace plans has to publish its provider directory as a data file. The figures count the doctors, clinics and hospitals each one lists at an address in Defiance County, across the 2026 plans it filed there. CareSource lists the most, 756 — but it is leaving this marketplace for 2027. MedMutual lists the fewest, 37.
| Insurer | Providers listed in Defiance County | Plans filed |
|---|---|---|
| CareSource (leaving this marketplace for 2027) | 756 | 13 |
| Anthem Blue Cross and Blue Shield | 688 | 11 |
| Ambetter from Buckeye Health Plan | 494 | 16 |
| Paramount | 456 | 15 |
| UnitedHealthcare | 269 | 17 |
| Antidote Health Plan of Ohio, Inc. | 183 | 15 |
| MedMutual | 37 | 12 |
| Molina Healthcare | not counted: its directory file blocks automated downloads | |
From each insurer’s own CMS machine-readable provider directory, downloaded September 25, 2026. A bigger number is not a promise about ProMedica. These files are self-reported, they go stale, and one insurer’s plans do not all use the same network — which is why a licensed agent checks the exact plan against ProMedica by hand above.
Open Enrollment 2027
CareSource is leaving Ohio's marketplace for 2027, and Open Enrollment runs 1 November 2026 to 15 January 2027. If your 2026 plan is from CareSource, the plan that replaces it is a different plan with its own network. A licensed agent can check ProMedica, and any doctors you name, against the plans filed in your county and send you the ones that include them, with the date it was checked.
Emergency care is treated differently
2 of these locations run an emergency room. Federal law requires marketplace plans to cover emergency care at in-network cost sharing even when the hospital is out of network, so an emergency visit is not the case to worry about. Planned surgery, imaging, maternity and specialist follow-up are where the network matters.
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