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Overview
In-network options (Tier 1 and 2) are based on the Mayo Medical Plan subscriber's state of residency. When you choose an in-network provider, you'll have lower out-of-pocket expenses (deductible, co-insurance, and out-of-pocket maximum).
Please note: You must confirm with the provider's office that they're in your plan's network before your first appointment and before every following appointment. Tier 1 and 2 are in-network for Mayo Medicare Supplement Plans.
Arizona Residents
|
Network Provider |
|||
|---|---|---|---|
Mayo Medical Plan Network |
Tier (s)1 |
Location of ServiceArizona |
Special NotesMayo Clinic providers are Tier 1. Durable medical equipment national suppliers are Tier 1. |
Blue Cross Blue Shield of Arizona PPO NetworkGeneral provider search |
Tier (s)1 & 2 |
Location of ServiceArizona |
Special NotesAdult services in audiology, oncology, cardiology, vascular surgery, endocrinology, nephrology, hepatology, and plastic surgery received through the BCBS network will be processed at Tier 2. All other services process at Tier 1. |
First Health Network |
Tier (s)2 |
Location of ServiceOutside of Arizona |
Special NotesAdditional providers are available through the First Health Network when you travel outside of Arizona. |
Out-of-network |
Tier (s)3 |
Location of ServicesOut-of-network |
Special NotesOther licensed providers nationwide.
Note: However, mental and behavioral health services performed by Tier 3 out-of-network providers will be processed at Tier 2 in-network benefits under the Mayo Medical Plan. Still, out-of-network providers may bill you for costs above the non-network provider reimbursement amount. |
Florida Residents
| Network Provider | |||
|---|---|---|---|
Mayo Medical Plan Network |
Tier (s)1 |
Location of ServicesFlorida |
Special NotesMayo Clinic providers are Tier 1.Durable medical equipment national suppliers are Tier 1. |
Private Healthcare System (PHCS) |
Tier (s)1 & 2 |
Location of ServicesFlorida |
Special NotesCustom PHCS Network providers. |
Zelis National Access ProgramGeneral provider search |
Tier (s)2 |
Location of ServicesOutside of Florida |
Special NotesAdditional providers are available through the Zelis Healthcare network when you travel outside of Florida. |
Out-of-network |
Tier (s)3 |
Location of ServicesOut-of-network |
Special NotesOther licensed providers nationwide. Note: However, mental and behavioral health services performed by Tier 3 out-of-network providers will be processed at Tier 2 in-network benefits under the Mayo Medical Plan. Still, out-of-network providers may bill you for costs above the non-network provider reimbursement amount |
Minnesota and Wisconsin Residents
|
Network provider |
|||
|---|---|---|---|
Mayo Medical Plan Network |
Tier (s)1 & 2 |
Location of ServicesMinnesota/Wisconsin |
Special NotesMayo Clinic providers are Tier 1.Durable medical equipment national suppliers are Tier 1. |
First Health Network |
Tier (s)2 |
Location of ServicesNationwide |
Special NotesAdditional providers are available through the First Health Network nationwide. |
Out-of-network providers |
Tier (s)3 |
Location of ServicesOut-of-network |
Special NotesOther licensed providers nationwide. Note: You and your eligible family members will be responsible for any charges above usual, customary, and reasonable rates when you get covered services at Tier 3 out-of-network providers. Those payments won't count toward your deductible and/or out-of-pocket maximum. However, mental and behavioral health services performed by Tier 3 out-of-network providers will be processed at Tier 2 in-network benefits under the Mayo Medical Plan. Still, out-of-network providers may bill you for costs above the non-network provider reimbursement amount. |
Residents of other states
|
Network provider |
|||
|---|---|---|---|
First Health Network |
Tier (s)1 |
Location of ServicesNationwide |
Special Notes
All First Health Network providers are Tier 1. |
Mayo Medical Plan Network |
Tier (s)1 & 2 |
Location of ServicesArizona, Florida, Minnesota, or Wisconsin |
Special NotesMayo Clinic providers are Tier 1. Durable medical equipment national suppliers are Tier 1. |
Out-of-network providers |
Tier (s)3 |
Location of ServicesOut-of-network |
Special NotesOther licensed providers nationwide. Note: However, mental and behavioral health services performed by Tier 3 out-of-network providers will be processed at Tier 2 in-network benefits under the Mayo Medical Plan. Still, out-of-network providers may bill you for costs above the non-network provider reimbursement amount. |
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