SOPHIA REBECCA BALDERMAN MD
Accepted Insurance for NPI 1104098607
Internal Medicine - Hematology in Cleveland, OH
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
SOPHIA REBECCA BALDERMAN MD, a internal medicine provider in Cleveland, OH, is listed as in-network for 37 health insurance plans from 2 insurance companies, led by CareSource and Oscar Insurance Corporation of Ohio. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
CareSource
Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness
Bronze 7500 $25 Generic Drugs
Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness
Core Gold 1500 $10 Generic Drugs
Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness
Diabetes Gold 3000 $0 Chronic Care Drugs & Services
Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness
Diabetes Silver 5000 $0 Chronic Care Drugs & Services
Gold 2000 $15 Generic Drugs + Adult Vision & Fitness
Gold 2000 $15 Generic Drugs
HDHP Preventive Silver 5500 $0 Chronic Care Drugs
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness
Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness
Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services
Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness
Low Premium Bronze 10600 $25 Generic Drugs
Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness
Low Premium Silver 6200 $3 Generic Drugs
Silver 6000 $20 Generic Drugs + Adult Vision & Fitness
Silver 6000 $20 Generic Drugs
Oscar Insurance Corporation of Ohio
Bronze Classic PCP Saver | Cleveland Clinic
Bronze Classic Standard | Cleveland Clinic
Bronze Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic
Bronze Simple Chronic Care CKM | Cleveland Clinic
Bronze Simple Diabetes | Cleveland Clinic
Bronze Simple HSA | Cleveland Clinic
Gold Classic Standard | Cleveland Clinic
Gold Elite Saver Plus | Cleveland Clinic
Gold Elite | Cleveland Clinic
Silver Classic Standard | Cleveland Clinic
Silver Elite Saver Plus | Cleveland Clinic
Silver Simple Breathe Easy with Enhanced COPD Benefits | Cleveland Clinic
Silver Simple Chronic Care CKM | Cleveland Clinic
Silver Simple Diabetes | Cleveland Clinic
Silver Simple PCP Saver | Cleveland Clinic
Silver Simple Women's Health with Menopause Benefits | Cleveland Clinic
Coverage Questions FAQs
Common questions about this provider’s insurance participation, answered from the CMS Health Insurance Marketplace and Medicare enrollment files.
What insurance does SOPHIA REBECCA BALDERMAN MD accept?
Marketplace files for the 2026 plan year list SOPHIA REBECCA BALDERMAN MD as in-network for 37 plans from 2 insurance companies. The largest networks are CareSource (21 plans), Oscar Insurance Corporation of Ohio (16 plans). The full list above shows each plan's metal level, network type, and plan IDs.
Is SOPHIA REBECCA BALDERMAN MD enrolled in Medicare?
Yes. CMS enrollment files show this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. The provider is also enrolled in PECOS, which certifies them to order, refer, and prescribe for Medicare beneficiaries.
What network types does SOPHIA REBECCA BALDERMAN MD participate in?
The accepted plans include 37 HMO plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists.
Where does this insurance data come from and how current is it?
Plan participation is compiled from the official CMS Health Insurance Marketplace public use files for the 2026 plan year and refreshed as CMS publishes updated files. Networks change during the year, so always verify coverage with the insurance company or the provider's office before scheduling care.
