Centers of Excellence
Centers of Excellence

Centers of Excellence: The best possible care for serious conditions

How it works

Walmart's Centers of Excellence (COE) program changes lives by partnering with top specialists for certain serious medical conditions and procedures, giving you easy access to the very best, most appropriate care possible.

 

Covered conditions

  • Certain heart surgeries, like cardiac bypass and valve replacements
  • Certain spine surgeries, like spinal fusions and removal of spinal discs (discectomy)
  • Hip and knee joint replacements
  • Breast, lung, colorectal, prostate, and blood cancers (including myeloma, lymphoma, and leukemia). Patients with these diagnoses may have their medical records reviewed by Mayo Clinic specialists to evaluate the benefit of an on-site visit to a Center of Excellence. If an on-site visit is recommended, the visit will be covered at 100 percent and will include a travel allowance.
  • Certain weight loss surgeries, like gastric bypass and gastric sleeve procedures
  • Organ and tissue transplants (except kidney, cornea, and intestinal), ventricular assist devices (VADs) and total artificial hearts, and CAR-T cell therapy
  • Outpatient radiology, which will be reviewed automatically through the pre-authorization program

 

Top hospitals

We select hospitals that have the expertise and resources to provide the highest-quality care for a number of serious medical conditions. And for many of these, treatment is covered at 100 percent, with a travel benefit for approved on-site visits.

The goal? Better results and fewer complications—it’s all part of how Walmart gives you easy access to better living!

Walmart has partnered with several world-class health systems across the country to serve the Centers of Excellence program, and a few of these include:

 

  • Cleveland Clinic, in Cleveland, Ohio, for cardiac surgery
  • Johns Hopkins Hospital, in Baltimore, Maryland, for joint replacement surgery
  • Mayo Clinic in Minnesota, Florida and Arizona, for transplants and cancer care
  • Geisinger Medical Center, in Danville, Pennsylvania, for weight loss surgery
  • Mercy Springfield, in Springfield, Missouri, for spine surgery

 

Here’s a map of all locations:

If you’re enrolled in certain Accountable Care Plans (ACP), you may have access to other COE facilities.

 

Coverage details

  • Participants enrolled in the HRA plan, HRA High plan, the HSA Plan, and a Select Network Plan are eligible. Some age limitations apply; generally, the patient must be at least 18 years old.
  • Associates enrolled in an ACP are also eligible. Some of these plans may have access to other facilities. Travel benefits for certain services may not be available for certain ACPs.
  • If you're enrolled in the HSA Plan, you'll be eligible for 100 percent coverage under the Centers of Excellence program after you meet your deductible, due to federal tax law.
  • Hip and knee replacements must be performed at a Centers of Excellence for network coverage. Non-emergency surgeries elsewhere are considered out-of-network and will be covered at 50 percent.
  • Spine surgeries and transplant care are only covered at designated Centers of Excellence. Non-emergency services anywhere else are not covered.
  • Weight loss surgeries are only covered at designated Centers of Excellence. In addition, these are covered at the regular benefit level of 75 percent after you meet your annual deductible, and no travel benefits are provided.

In addition to the full cost of treatment for many conditions, the benefit includes travel and lodging expenses for both the patient and a companion caregiver. Travel and lodging are not included for the weight-loss-surgery benefit.

 

Get access

  • If your doctor recommends a surgery or you have a cancer diagnosis that’s listed above, call your health care advisor at the phone number on your plan ID card.

 

See the 2018 Associate Benefits Book with 2019 Summary of Material Modifications for additional information about your benefits and eligibility. Those documents will control in the event of any conflict.

Contacts & Helpful Links

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