DR. RAFAEL CARTAYA MD
Accepted Insurance for NPI 1417616632
General Practice in Miami, FL
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
DR. RAFAEL CARTAYA MD, a general practice provider in Miami, FL, is listed as in-network for 210 health insurance plans from 7 insurance companies, led by Oscar Insurance Company, Oscar Health Maintenance Organization of Florida and Molina Healthcare. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
Ambetter Health
Clarity Silver
Complete Gold + Vision + Adult Dental
Complete Gold
Elite Bronze + Vision + Adult Dental
Elite Bronze
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental
Enhanced Diabetes Care Silver with $0 Drug Options
Everyday Bronze + Vision + Adult Dental
Everyday Bronze
Everyday Gold + Vision + Adult Dental
Everyday Gold
Focused Silver + Vision + Adult Dental
Focused Silver
Standard Expanded Bronze + Vision + Adult Dental
Standard Expanded Bronze
Standard Gold + Vision + Adult Dental
Standard Gold
Standard Silver + Vision + Adult Dental
Standard Silver
Thrive Silver
Ambetter of Alabama
Complete Gold + Vision + Adult Dental
Complete Gold
Elite Bronze + Vision + Adult Dental
Elite Bronze
Elite Gold + Vision + Adult Dental
Elite Gold
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental
Enhanced Diabetes Care Silver with $0 Drug Options
Everyday Bronze + Vision + Adult Dental
Everyday Bronze
Focused Silver + Vision + Adult Dental
Focused Silver
Standard Expanded Bronze + Vision + Adult Dental
Standard Expanded Bronze
Standard Gold + Vision + Adult Dental
Standard Gold
Standard Silver + Vision + Adult Dental
Standard Silver
AmeriHealth Caritas Next
AmeriHealth Caritas Next Bronze Essential + No Referrals
AmeriHealth Caritas Next Bronze Premier + No Referrals
AmeriHealth Caritas Next Bronze Signature + No Referrals
AmeriHealth Caritas Next Gold Premier + No Referrals
AmeriHealth Caritas Next Gold Signature + No Referrals
AmeriHealth Caritas Next Silver Essential + No Referrals
AmeriHealth Caritas Next Silver Premier + No Referrals
AmeriHealth Caritas Next Silver Signature + No Referrals
AvMed
AvMed Entrust Bronze 600 (2026)
AvMed Entrust Bronze 650 (2026)
AvMed Entrust Expanded Bronze Standard (2026)
AvMed Entrust Gold 125 (2026)
AvMed Entrust Gold 125 Dental+Vision (2026)
AvMed Entrust Gold Standard (2026)
AvMed Entrust Platinum 25 (2026)
AvMed Entrust Platinum 25 Dental+Vision (2026)
AvMed Entrust Platinum Standard (2026)
AvMed Entrust Silver 350 (2026)
AvMed Entrust Silver 350 Dental+Vision (2026)
AvMed Entrust Silver 550 (2026)
AvMed Entrust Silver 550 Dental+Vision (2026)
AvMed Entrust Silver Standard (2026)
Molina Healthcare
Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision
Molina Bronze Enhanced 3500 Plus with Adult Vision
Molina Bronze Enhanced 3500
Molina Bronze Premier with $0 Medical Deductible Plus with Adult Dental and Vision
Molina Bronze Premier with $0 Medical Deductible Plus with Adult Vision
Molina Bronze Premier with $0 Medical Deductible
Molina Bronze Standard
Molina Gold Core 1640 Plus with Adult Dental and Vision
Molina Gold Core 1640 Plus with Adult Vision
Molina Gold Core 1640
Molina Gold Enhanced 895 Plus with Adult Dental and Vision
Molina Gold Enhanced 895 Plus with Adult Vision
Molina Gold Enhanced 895
Molina Gold Standard
Molina Silver Access Plus with Adult Dental and Vision
Molina Silver Access Plus with Adult Vision
Molina Silver Access
Molina Silver Core Plus with Adult Dental and Vision
Molina Silver Core Plus with Adult Vision
Molina Silver Core
Molina Silver Saver with Four Free PCP Visits
Molina Silver Standard
Oscar Health Maintenance Organization of Florida
Bronze Classic 4700 | with AdventHealth
Bronze Classic 4700
Bronze Classic Standard | with AdventHealth
Bronze Classic Standard
Bronze Elite + PCP Saver Plus | with AdventHealth
Bronze Elite + PCP Saver Plus
Bronze Simple Breathe Easy with Enhanced COPD Benefits
Bronze Simple Chronic Care CKM
Bronze Simple Diabetes
Gold Classic Standard | with AdventHealth
Gold Classic Standard
Gold Elite Saver Plus | with AdventHealth
Gold Simple | with AdventHealth
Gold Simple
Silver Classic Standard | with AdventHealth
Silver Classic Standard
Silver Elite | with AdventHealth
Silver Elite
Silver Simple Breathe Easy with Enhanced COPD Benefits
Silver Simple Chronic Care CKM | with AdventHealth
Silver Simple Chronic Care CKM
Silver Simple Diabetes | with AdventHealth
Silver Simple Diabetes
Silver Simple PCP Saver | with AdventHealth
Silver Simple PCP Saver
Silver Simple Women's Health with Menopause Benefits
Oscar Insurance Company
Bronze Classic 4700 | MercyOne
Bronze Classic 4700
Bronze Classic Standard | MercyOne
Bronze Classic Standard
Bronze Elite + PCP Saver Plus | MercyOne
Bronze Elite + PCP Saver Plus
Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOne
Bronze Simple Chronic Care CKM | MercyOne
Bronze Simple Diabetes | MercyOne
Gold Classic Standard | MercyOne
Gold Classic Standard
Gold Elite | MercyOne
Gold Elite
Secure | MercyOne
Secure
Silver Classic Standard | MercyOne
Silver Classic Standard
Silver Classic | MercyOne
Silver Classic
Silver Simple Breathe Easy with Enhanced COPD Benefits | MercyOne
Silver Simple Chronic Care CKM | MercyOne
Silver Simple Diabetes | MercyOne
Silver Simple Diabetes
Silver Simple PCP Saver | MercyOne
Silver Simple PCP Saver
Silver Simple Women's Health with Menopause Benefits | MercyOne
Coverage Questions FAQs
Common questions about this provider’s insurance participation, answered from the CMS Health Insurance Marketplace and Medicare enrollment files.
What insurance does DR. RAFAEL CARTAYA MD accept?
Marketplace files for the 2026 plan year list DR. RAFAEL CARTAYA MD as in-network for 210 plans from 7 insurance companies. The largest networks are Oscar Insurance Company (26 plans), Oscar Health Maintenance Organization of Florida (26 plans), Molina Healthcare (22 plans), followed by 4 more companies. The full list above shows each plan's metal level, network type, and plan IDs.
Is DR. RAFAEL CARTAYA MD enrolled in Medicare?
Yes. CMS enrollment files show this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. The provider is also enrolled in PECOS, which certifies them to order, refer, and prescribe for Medicare beneficiaries.
What network types does DR. RAFAEL CARTAYA MD participate in?
The accepted plans include 90 HMO plans and 44 EPO plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists. EPO (Exclusive Provider Organization) plans cover network providers only, generally without referral requirements.
Where does this insurance data come from and how current is it?
Plan participation is compiled from the official CMS Health Insurance Marketplace public use files for the 2026 plan year and refreshed as CMS publishes updated files. Networks change during the year, so always verify coverage with the insurance company or the provider's office before scheduling care.
