Overview
Here’s an overview of how the Mayo Medical Plan tiers are defined:
Tier 1 Providers (In-network)
Includes Mayo Clinic providers.
Tier 2 Providers (In-network)
Includes approved Medica-contracted providers and leased network providers.
Tier 3 (Out-of-network)
Includes other licensed providers nationwide.
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 NetworkGeneral provider search for 2022Durable medical equipment search for 2022 |
Tier (s)1
|
Location of ServiceArizona
|
Special NotesMayo Clinic providers are Tier 1.
Additional Medica-contracted providers are available to you in Minnesota and surrounding states at Tier 1 or Tier 2. See the general provider search for details.
|
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 are available from Tier 2 providers but not from Tier 1 providers. |
First Health NetworkGeneral provider search |
Tier (s)2 |
Location of ServiceOutside of Arizona |
Special Notes
Additional 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: 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. |
Florida Residents
|
Network Provider |
|||
|---|---|---|---|
Mayo Medical Plan NetworkGeneral provider search for 2022Durable medical equipment search for 2022 |
Tier (s)1 |
Location of ServicesFlorida |
Special NotesMayo Clinic providers are Tier 1.
|
Private Healthcare System (PHCS)General provider search |
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 Notes Additional 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: 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. |
Minnesota and Wisconsin Residents
|
Network provider |
|||
|---|---|---|---|
Mayo Medical Plan NetworkGeneral provider search for 2022Durable medical equipment search for 2022 |
Tier (s)1 & 2
|
Location of ServicesMinnesota/Wisconsin |
Special NotesMayo Clinic providers are Tier 1. Additional Medica-contracted providers are available to you in Minnesota and surrounding states at Tier 1 or Tier 2. See the general provider search for details. |
First Health NetworkGeneral provider search |
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 Notes
Other licensed providers nationwide. |
Residents of other states
|
Network provider |
|||
|---|---|---|---|
Mayo Medical Plan NetworkGeneral provider search for 2022Durable medical equipment search for 2022 First Health NetworkGeneral provider search |
Tier (s)1
|
Location of ServicesArizona, Florida, Minnesota, or Wisconsin Nationwide |
Special NotesMayo Clinic providers are Tier 1.
All First Health Network providers are Tier 1. |
Out-of-network providers |
Tier (s)3 |
Location of ServicesOut-of-network |
Special Notes
Other licensed providers nationwide. |
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