CARL DUANE MATHEWS JR. LPCC
Accepted Insurance for NPI 1982265310
Counselor - Mental Health in Kinsman, OH
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
CARL DUANE MATHEWS JR. LPCC, a counselor provider in Kinsman, OH, is listed as in-network for 102 health insurance plans from 6 insurance companies, led by CareSource, Anthem Blue Cross and Blue Shield and UnitedHealthcare. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
Anthem Blue Cross and Blue Shield
Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs)
Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs)
Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs)
Anthem Bronze Pathway 8500 for HSA
Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)
Anthem Bronze Preferred/Broad HSA (+ Incentives)
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs)
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs)
Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives)
Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs)
Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs)
Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs)
Anthem Silver Pathway 5500 for HSA
Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs)
Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives)
Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)
Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)
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
MedMutual
Bronze $8,300 w/ Adult Dental ON-EX
Bronze $8,300 w/ Virtual & Wellness ON-EX
Bronze HSA $7,300 ON-EX
Bronze Standard w/ Virtual & Wellness
Gold $1,000 w/ Adult Dental ON-EX
Gold $1,000 w/ Virtual & Wellness ON-EX
Gold $500 w/ Virtual & Wellness ON-EX
Gold Standard w/ Virtual & Wellness
Silver $5,000 w/ Adult Dental ON-EX
Silver $5,000 w/ Virtual & Wellness ON-EX
Silver $5,800 w/ Virtual & Wellness ON-EX
Silver Standard w/ Virtual & Wellness
Oscar Health Insurance
Bronze Classic 4700
Bronze Classic Standard
Bronze Elite + PCP Saver Plus
Bronze Simple Breathe Easy with Enhanced COPD Benefits
Bronze Simple Chronic Care CKM
Bronze Simple Diabetes
Gold Classic Standard
Gold Classic
Gold Elite Saver Plus
Silver Classic Standard
Silver Elite Saver Plus
Silver Simple Breathe Easy with Enhanced COPD Benefits
Silver Simple Chronic Care CKM
Silver Simple Diabetes
Silver Simple PCP Saver
Silver Simple Women's Health with Menopause Benefits
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
UnitedHealthcare
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals)
UHC Bronze Standard (No Referrals)
UHC Bronze Standard+ (Dental + Vision, No Referrals)
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals)
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals)
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
UHC Gold Standard (No Referrals)
UHC Gold Standard+ (Dental + Vision, No Referrals)
UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals)
UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals)
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
UHC Silver Standard (No Referrals)
UHC Silver Standard+ (Dental + Vision, No Referrals)
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 CARL DUANE MATHEWS JR. LPCC accept?
Marketplace files for the 2026 plan year list CARL DUANE MATHEWS JR. LPCC as in-network for 102 plans from 6 insurance companies. The largest networks are CareSource (21 plans), Anthem Blue Cross and Blue Shield (20 plans), UnitedHealthcare (17 plans), followed by 3 more companies. The full list above shows each plan's metal level, network type, and plan IDs.
Is CARL DUANE MATHEWS JR. LPCC enrolled in Medicare?
The CMS enrollment files for this NPI show a PECOS enrollment record, which certifies the provider to order, refer, and prescribe for Medicare beneficiaries. The files do not currently show a Medicare assignment indicator; verify Medicare participation directly with the practice.
What network types does CARL DUANE MATHEWS JR. LPCC participate in?
The accepted plans include 93 HMO plans and 9 POS plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists. POS (Point of Service) plans combine HMO-style referrals with partial out-of-network coverage.
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.
