Finding an In-Network Provider for your health plans
Attention team members with UF Health Central Florida insurance: Please use the Blue Cross Blue Shield network directory at MyHealthToolkit to identify which physicians are classified in the “BlueOptions” network using the app or Google Chrome search engine (other search engines may not work for this site). Enter the letters “KXK”, which can be found on your Blue Cross Blue Shield membership card and hit “continue” to find a doctor in network.
Using a Blue Options provider ensures that you will receive the highest level of insurance coverage for your visit and services.
To maximize your insurance benefit coverage and to have your claims for the office visit paid at the highest level, please select a physician from the BlueOptions network. However, to receive the highest level of coverage for any procedure (i.e. lab work, diagnostic imaging, etc.) or hospitalization/inpatient stay, you must use a UF Health Central Florida facility. If you need to have a procedure done elsewhere (including in a doctor’s office), you must complete the Request for Pre-Approval waiver and receive approval on the waiver before receiving any service or procedure. Failure to complete and receive approval on the waiver before the procedure will result in coverage dropping to Tier 2 or Tier 3 levels, making your out-of-pocket costs higher.
To ensure that the physician you choose on the BlueOptions network has privileges with a UF Health Central Florida facility, when on the network directory, click “Hospital Affiliations” and select the boxes next to UF Health Leesburg Hospital or UF Health The Villages® Hospital. That selection will filter the list by only in-network doctors who have privileges in our UF Health Central Florida facilities.
UF Health Central Florida also updates our own Provider Directory regularly to show all physicians with hospital privileges. Click https://www.centralfloridahealth.org/provider-directory/ to find the most up-to-date listing. Having privileges with a UF Health Central Florida facility does not ensure participation in the Blue Cross Blue Shield network. You should cross-verify with the BlueOptions network directory.
If your doctor wants to do a lab, diagnostic imaging, or other ancillary procedure or service in his/her office during your visit, please remind him/her that in order to minimize your out-of-pocket expense, you will need to get those procedures or services done at a UF Health Central Florida facility when the service/procedure is available there. If the procedure or service is not available at a UF Health Central Florida facility, then you will need to complete the Request for Pre-Approval waiver and receive approval on the waiver before the procedure or service is performed in order to get the service or procedure paid at a Tier 1 level.
Jessica Peterson, DO; Juan Rios, MD; and Shawn McNichol, PA are members of the UF Health Central Florida network, but are not listed on the BlueOptions network listings. Please be assured that all three of the above named practitioners will be covered at the in-network Tier 1 rates.
UF Health Central Florida dental insurance is provided by MetLife. To find a list of MetLife in-network dentists, please go to www.metlife.com. Click “Find a Dentist” and select “PDP Plus.” The site will direct you to enter your zip code and will give you a list of the nearest providers.
UF Health Central Florida vision insurance is provided by Humana and utilizes the EyeMed network. Go to the Humana Vision Provider website and type in your zip code to search.
UF Health Central Florida provides pharmacy benefits through Magellan Rx. The retail pharmacy at UF Health Leesburg Hospital is part of the network and will offer the best prices for team members and dependents. The retail pharmacy team can be reached at 352.323.5384 or you can visit MagellanRX.com or go to this helpful Magellan Pharmacy Network page to find other in-network pharmacies.
If you have questions regarding your health benefits, call the Human Resources Department.
Last names A-F, call Donelle Franklin at 352.323.5574
Last names G-O, call Maranda Strickland at 352.323.4147
Last names P-Z, call Jasmine Nieves at 352.323.4143