More About Insurance Accepted

Participating Insurance Plans

Note: Dr. Benavidez makes every attempt to contract with as many payors as possible in order to improve access to care and cut out of pocket expenses for patients. Many of the insurance companies that Dr. Benavidez does not accept are difficult to panel with due to provider saturation or closed network status. Thank you for your patience..

Surgery evaluations

• We are contracted with Scripps Medical Group to provide surgery evaluations to those with coverage through Kaiser, Carrum, or Community Health Group (CHG). There is no copay for those with this type of coverage.

• We take the following government-sponsored insurances: Medicare and Tricare. We accept the following commerical insurances: Aetna and United Healthcare. Your copay depends on your specific plan and the status of your deductible/out-of-pocket amount. If you are unsure whether you have a copay, contact your insurer before the appointment with Dr. Benavidez. Even if you have insurance coverage, you may be responsible for the total cost of the evaluation ($200) if you have not met your deductible. If you are unsure whether you have met your deductible, please contact the insurer listed on your insurance card.

• Although we certainly do appreciate employees of Scripps, we do not currently accept Scripps EPO (We do not accept the healthcare plan provided to Scripps employees). Scripps employees and those with Scripps EPO coverage should contact the number listed on the back of your insurance card.

Medicare

• We are credentialed with and accept the government-sponsored insurance, Medicare. However, we do not accept Medicare Advantage plans administered through third party insurance companies even if we accept that third party insurer's coverage (UHC, Aetna, etc...).

• We accept Medicare/MediCal crossover insurance. However, we do not accept MediCal as a primary insurance currently.

Optum

Optum is inclusive of several health plans that are covered including:

• UnitedHealthcare

• UnitedHealthcare Shared Services (UHSS)

• UnitedHealthcare Global

• UnitedHealthCare Exchange Plans (ONEX)

• Oscar

• Oxford

• UHC Student Resources

• UMR

• All Savers (UHC)

• Health Plans Inc

• Surest (Formerly Bind)

Optum is inclusive of several health plans that we do not currently accept, including:

• Select Health

• Health Plans of Nevada

• Cenpatico

• Sierra Health and Life Health Plans

• Arizona Complete Health

• Optum Medicare and Medicaid plans

Aetna

Included in Aetna's Signature Administrators are the following:

• Meritain

• Nippon

• Allied Benefit Systems

• Trustmark

• Trustmark Small Business Benefits

• Health Scope

• Christian Brothers Services

Aetna is inclusive of several health plans that I do not currently accept, including:

• GEHA - Aetna**

• Boon Chapman

• AmeriBen

• Health First

• Piedmont/S&S Healthcare

• Health Smart

• Emi Health

• WebTPA

• Aetna Medicare and Medicaid plans

** GEHA - Aetna is not currently accepted UNLESS the plan includes mental health benefits managed by United Healthcare Shared Services.