At Mayo Clinic's campus in Arizona, Mayo Clinic providers and Mayo Clinic Hospital are contracted with the organizations listed below.

Insurance types include: Commercial, International, and Transplant.

Your benefit coverage for care provided by Mayo Clinic is determined solely by your insurance company and is based on the provisions of your specific medical benefit plan.

Please contact the customer service department on the back of your member identification card to confirm if you have in-network access to Mayo Clinic, as well as your benefit level, for care provided at Mayo Clinic.

You may also contact Mayo Clinic directly at 844-217-9591 (Toll-Free) or 507-266-0909 (International) for more details about the information listed below.

Commercial Insurance Plan Contracts

Aetna • Aetna Choice POS II • Aetna Choice • Aetna Choice Plus • Aetna Choice POS • Aetna Choice POS (Aetna HealthFund) • Aetna Choice POS (Open Access) • Aetna Choice POS II (Aetna HealthFund) • Aetna Choice POS II (Open Access) • Aetna Health Network Only (Open Access) • Aetna Health Network Option (Open Access) • Aetna HealthFund Aetna Health Network Only (Open Access) • Aetna HealthFund Aetna Health Network Option (Open Access) • Aetna Open Access • Aetna Open Access Elect Choice EPO (Aetna HealthFund) • Aetna Open Access Managed Choice POS (Aetna HealthFund) • Aetna PPO • Aetna Select • Aetna Select Open Access • Aetna Select Open Access/Aetna Select • Aetna Signature Administrators (ASA) • Aetna Student Health Plans • Aexcel Aetna Select • Aexcel Aetna Select (Open Access) • Aexcel Choice POS II • Aexcel Choice POS II (Aetna HealthFund) • Aexcel Elect Choice EPO • Aexcel Elect Choice EPO (Open Access)

• Aexcel Managed Choice POS • Aexcel Managed Choice POS (Open Access) • Aexcel Open Access Aetna Select (Aetna HealthFund) • Aexcel Open Access Elect Choice (Aetna HealthFund) • Aexcel Open Access Managed Choice POS (Aetna HealthFund) • Aexcel Plus Aetna Select • Aexcel Plus Aetna Select (Open Access) • Aexcel Plus Choice POS II • Aexcel Plus Choice POS II (Aetna HealthFund) • Aexcel Plus Elect Choice EPO • Aexcel Plus Elect Choice EPO (Open Access) • Aexcel Plus Managed Choice POS • Aexcel Plus Managed Choice POS (Open Access) • Aexcel Plus Open Access Aetna Select (Aetna HealthFund) • Aexcel Plus Open Access Elect Choice (Aetna HealthFund) • Aexcel Plus Open Access Managed Choice POS (Aetna HealthFund) • Aexcel Plus PPO • Aexcel Plus PPO (Aetna HealthFund) • Aexcel PPO • Aexcel PPO (Aetna HealthFund) • Choice Plus • Choice POS • Choice POS II • CP II • Elect Choice • Elect Choice EPO • Elect Choice EPO (Open Access) • Elect Choice Open Access/Elect Choice • EPO • EPO Plus • EPO Plus/Open Access EPO Plus • Health Network Only • Health Network Option • HMO • HMO (Open Access) • HMO HNO • HMO/Health Network Only • HMO/Open Access HMO (Banner) • HNOnly • Managed Choice • Managed Choice POS • Managed Choice POS • Managed Choice POS (Open Access) • Managed Plus/Open Access Managed Plus • Managed Plus/Open Access Managed Plus (Banner) • OA HMO

• Open Access (OA) HMO • Open Access Aetna Select • Open Access Aetna Select (Aetna HealthFund) • Open Access Elect Choice • Open Access Elect Choice EPO • Open Access EPO Plus • Open Access HMO • Open Access Managed Choice • Open Access MC • Open Access POS • Open Access POS II • Open Access POS II (Banner) • Open Choice PPO • Open Choice PPO (Aetna HealthFund) • Passport to Healthcare® (PTH) • PPO • QPOS • Traditional Choice

Alliance Coal Health Plan (complex care – referral required) Allied Benefit Systems, Inc. (select employer groups) Allstate Benefits (select employer groups) Arizona Foundation for Medical Care Beech Street Benefit Systems and Services, Inc (select employer groups) Blue Cross Blue Shield • BCBS Out-of-state BlueCard members (i.e. ID cards with a suitcase logo on the card from Anthem BCBS of California) have in-network access • BCBS Select Arizona PPO and EPO employer groups

Central States Health and Welfare Fund Cigna • Cigna HealthCare/Great-West Healthcare • Cigna Choice Fund Open Access Plus • Cigna EPO and PPO • Cigna HMO Open Access • Cigna HMO, Network, POS • Cigna Indemnity • Cigna HMO or POS Open Access • Cigna Open Access Plus • GHW-Cigna Open Access Plus City of Henderson

Coventry

• Coventry Health Care National Network (select employer groups) • Coventry Health and Life of Iowa, Nebraska and South Dakota (includes commercial HMO plans)

Ed Miniat, Inc. (EDI) First Health Network Fiserv/UMR (select employer groups) Galaxy Health Network Georgia Health Network HCC Life Insurance Company (HCCL) Health Alliance Medical Plans (select employer groups) HealthEZ (select employer groups) Health Plans INC (complex care program – referral required) HealthSCOPE Benefits (select employer groups) Health Utah Management Humana • Humana ChoiceCare Plus • Humana National POS Open Access Plus • Insurance Management Administrators (IMA) Interlink Health (Cancer Care Program) Medica Mayo Employee Plan Meritain Health (select employer groups) MidMichigan Health Network MultiPlan (verify benefit level with insurance) North Central Healthcare Alliance, Inc. Pekin • Pekin Life Insurance Company • Pekin - Group Plan Solutions (select employer groups) Physicians Plus Insurance Corp. (referral required) PreferredOne Administrative Services Preferred One PPO Private Healthcare Systems (PHCS) Professional Benefit Administrators (select employer groups) Purdue University Sanford Health Plan (referral required) Security Health Plan (commercial plans) Sheboygen Employers Health Network Star Healthcare Network, Inc. (domestic) Summit Management Services, Inc (select employer groups) Trilogy (select employer groups)

UnitedHealthcare • UnitedHealthCare Choice or Choice Plus • UnitedHealthCare Combined Govt Health Plan • UnitedHealthCare Compass Rose Health Plan • UnitedHealthCare Core, Choice, or Core Choice Plus • UnitedHealthCare Empire Health Plan (select employer groups) • UnitedHealthCare Employees • UnitedHealthCare GEHA Choice Plus or GEHA Options PPO • UnitedHealthCare Harvard Pilgrim Choice Plus or Harvard Pilgrim Options PPO • UnitedHealthCare Indemnity

• UnitedHealthCare Medica Commercial Options PPO (with travel benefit)

• UnitedHealthCare Medica Passport Choice Plus or Medica Passport Options PPO • UnitedHealthCare Options PPO • UnitedHealthCare Oxford (select employer groups) • UnitedHealthCare River Valley (select employer groups) • UnitedHealthCare Select, Select Plus, Select EPO, or Select Plus EPO • UnitedHealthCare Student Resources Choice Plus or Student Resources Options PPO • UnitedHealthCare UMR • UnitedHealthCare UMR Choice Plus or UMR Options PPO

United Security Life and Health (select employer groups) University of Minnesota USA Managed Care Organization Yampa Valley Medical Center

International

Allianz Partners Allianz/World access (Europe) Arizona Foundation for Medical Care-International (prior auth needed) AXA Assistance USA, Inc. (Verification of Benefits/Letter of Guarantee needed) Axis Services, LLC Beijing Huimei Best Technology Co, LTD (Huimei Best) Best Doctors, Inc. (aka Primary Group) BMI Services, Inc Blue Cross of Jamaica Blue Cross Blue Shield of Panama, Uruguay (Swiss Medical) and U.S. Virgin Islands Blue Cross (La Cruz Azul de Puerto Rico) and Blue Shield (Triple S) of Puerto Rico Cigna (Vanbreda International) Clalit CorVel Healthcare Corporation Federal Assist – MAPFRE International Assistance System/MAPFRE PPO GEO Blue Global Excel Management Grupo Nacional Provincial Health Hub USA LLC Hygeia International Managed Care Services of Puerto Rico (IMACs) Intellicare (Asalus) Pan American Life Insurance Group (PALIG) Plotkin Health Quality Health Management (QHM) QTC Star Healthcare Network, Inc. St. Lucia SunMed International UnitedHealthcare International UnitedHealthCare Choice Plus UnitedHealthCare International Options PPO Vanbreda International WorldWide Concierge Health Services WorldCare/Global Health Services

Transplant only

Aetna, Institutes of Excellence Facility Allianz (LifeTrac Network) Arizona Health Care Cost Containment System Blue Cross Blue Shield, Blue Distinction Center Cigna LifeSOURCE Transplant Network Humana National Transplant Network INTERLINK Health Services (Medical Excellence Network) Kaiser Permanente OptumHealth (formerly United Resource Networks) Pekin Life Insurance Company Protocol Tertiary Networks Wal-Mart Stores Inc.

09/23/21