DR. ALEJANDRO MARTINEZ ALVARADO
Accepted Insurance for NPI 1982969150
Dentist - General Practice in San Antonio, TX

Q: What managed care network types are accepted by this provider?

DR. ALEJANDRO MARTINEZ ALVARADO is enrolled across the following managed care network types: EPO, HMO, POS, PPO. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.

NPI Status: Active since July 12, 2012

Contact Information

4416 RAMSGATE ST STE 202
SAN ANTONIO, TX
ZIP 78230
Phone: (210) 690-5555
Fax: (210) 694-5066

Get Directions

Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with DR. ALEJANDRO MARTINEZ ALVARADO, a practicing dentist professional in San Antonio, TX. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 276 individual coverage options managed by medical networks, including networks like Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, and Ambetter from Louisiana Healthcare Connections. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

Insurance Carrier Navigation Index

Ambetter from Arizona Complete Health
Ambetter from Arkansas Health & Wellness
Ambetter from Louisiana Healthcare Connections
Ambetter from Superior HealthPlan
Ambetter Health
Ambetter of Oklahoma
Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Montana
Blue Cross and Blue Shield of Oklahoma
Blue Cross and Blue Shield of Texas
DentaQuest USA Insurance Company, Inc.
Dominion National
Florida Combined Life
Guardian
Humana
Renaissance Dental
UnitedHealthcare

Search Insurance Plans

Filter By Insurance Company

Fitler by Network Type

Ambetter Health

Clarity VALUE Silver

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050014

Complete VALUE Gold

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050010

Elite VALUE Bronze

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050005

Focused VALUE Silver

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050009

Standard Expanded Bronze VALUE

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050017

Standard Gold VALUE

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050019

Standard Silver VALUE

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

86382FL0050018

Ambetter from Arizona Complete Health

Choice Bronze HSA

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080037

Choice Bronze HSA + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180037

Complete Gold

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080059

Complete Gold + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180059

Complete Silver

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080044

Complete Silver + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180044

Elite Gold

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080113

Elite Gold + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180113

Everyday Bronze

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080119

Everyday Bronze + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180119

Standard Expanded Bronze

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080122

Standard Expanded Bronze + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180104

Standard Gold

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080124

Standard Gold + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180106

Standard Silver

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0080123

Standard Silver + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

91450AZ0180105

Ambetter from Arkansas Health & Wellness

Choice Bronze HSA (QualChoice)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0070285

Complete Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080014

Complete Gold + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100014

Connected Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080007

Connected Silver (QualChoice)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0070261

Connected Silver (QualChoice) + Vision + Adult Dental

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0210001

Connected Silver (QualChoiceLife)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0070025

Connected Silver (QualChoiceLife) + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0160003

Connected Silver + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100007

Elite Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080026

Elite Bronze + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100026

Elite Gold (QualChoice)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0070268

Elite Gold (QualChoice) + Vision + Adult Dental

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0210002

Elite Gold (QualChoiceLife)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0070031

Elite Gold (QualChoiceLife) + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0160002

Everyday Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080017

Everyday Bronze + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100017

Standard Expanded Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080032

Standard Expanded Bronze (QualChoice)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0070287

Standard Expanded Bronze + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100033

Standard Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080034

Standard Gold (QualChoice)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0070289

Standard Gold (QualChoice) + Vision + Adult Dental

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0210003

Standard Gold (QualChoiceLife)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0070034

Standard Gold (QualChoiceLife) + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0160001

Standard Gold + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100035

Standard Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0080033

Standard Silver (QualChoice)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0070288

Standard Silver (QualChoice) + Vision + Adult Dental

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

70525AR0210005

Standard Silver (QualChoiceLife)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

37903AR0070033

Standard Silver + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62141AR0100034

Ambetter from Louisiana Healthcare Connections

Complete Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010006

Complete Gold + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020005

Elite Bronze

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010002

Elite Bronze + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020002

Elite Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010008

Elite Gold + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020008

Everyday Bronze

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010001

Everyday Bronze + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020001

Focused Silver

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010005

Focused Silver + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020004

Standard Expanded Bronze

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010009

Standard Expanded Bronze + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020009

Standard Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010011

Standard Gold + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020011

Standard Silver

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0010010

Standard Silver + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

90787LA0020014

Ambetter from Superior HealthPlan

Complete Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0140064

Complete Gold + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0160020

Complete VALUE Gold

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87226TX006001387226TX007001387226TX0100013

Enhanced Diabetes Care Silver with $0 Drug Options

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0140049

Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0160053

Everyday Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0140102

Everyday Gold + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0160102

Focused Silver

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0140100

Focused Silver + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0160100

Focused VALUE Silver

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87226TX006000987226TX007000987226TX0100009

Focused VALUE Silver + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87226TX012000187226TX013000387226TX0140003

Standard Gold

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0140109

Standard Gold + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0160052

Standard Gold VALUE

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87226TX006001287226TX007001287226TX0100012

Standard Silver

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0140108

Standard Silver + Vision + Adult Dental

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

29418TX0160054

Standard Silver VALUE

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87226TX006001187226TX007001187226TX0100011

Standard Silver VALUE + Vision + Adult Dental

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87226TX012000587226TX013000287226TX0140004

Ambetter of Oklahoma

Elite Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120006

Elite Bronze + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130006

Elite Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120016

Elite Gold + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130017

Enhanced Asthma/COPD Care Silver with $0 Drug Options

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120023

Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130023

Enhanced Diabetes Care Silver with $0 Drug Options

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120024

Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130024

Everyday Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120002

Everyday Bronze + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130002

Everyday Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120014

Everyday Gold + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130014

Focused Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120012

Focused Silver + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130012

Standard Expanded Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120019

Standard Expanded Bronze + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130019

Standard Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120021

Standard Gold + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130021

Standard Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0120020

Standard Silver + Vision + Adult Dental

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

62505OK0130025

Blue Cross and Blue Shield of Alabama

Blue HSA Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0560001

Blue Protect

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0470001

Blue Saver Bronze

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0460001

Blue Standardized Statewide Silver EPO

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0780001

Blue Statewide Silver EPO

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0770001

Blue Value Gold

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0370001

Blue Value Silver

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0410001

Blue Access Gold for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0340001

Blue Choice Platinum for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0280001

Blue HSA Silver for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0680001

Blue Saver Bronze for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0430001

Blue Saver Gold for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0760001

Blue Secure Gold for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0670001

Blue Secure Silver for Business

PPO Group

Market Classification Rank: SHOP (Small Group) Coverage Framework

Assigned Option Status: TIER-ONE Tier

Accepted Plan ID Variations

46944AL0380001

Blue Cross and Blue Shield of Montana

BlueCare Dental 4 Kids? 1A

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

30751MT0580003

BlueCare Dental 4 Kids? 1B

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

30751MT0580004

BlueCare Dental? 1A

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

30751MT0580001

BlueCare Dental? 1B

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

30751MT0580002

BlueCare Dental? 1C

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

30751MT0580005

BlueCare Dental? 1D

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

30751MT0580006

Blue Cross and Blue Shield of Oklahoma

BlueCare Dental 4 Kids? 1A

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87571OK0390003

BlueCare Dental 4 Kids? 1B

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87571OK0390004

BlueCare Dental? 1A

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87571OK0390001

BlueCare Dental? 1B

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87571OK0390002

BlueCare Dental? 1C

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87571OK0390005

BlueCare Dental? 1D

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87571OK0390006

Blue Cross and Blue Shield of Texas

BlueCare Dental 1D

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

33602TX0500007

BlueCare Dental 4 Kids? 1A

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

33602TX0500003

BlueCare Dental 4 Kids? 1B

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

33602TX0500004

BlueCare Dental? 1A

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

33602TX0500001

BlueCare Dental? 1B

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

33602TX0500002

BlueCare Dental? 1C

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

33602TX0500006

DentaQuest USA Insurance Company, Inc.

DentaQuest PPO Pediatric High

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NULL Tier

Accepted Plan ID Variations

58609TX0010001

DentaQuest PPO Family Basic

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NULL Tier

Accepted Plan ID Variations

58609TX0010006

DentaQuest PPO Family High

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NULL Tier

Accepted Plan ID Variations

58609TX0010003

DentaQuest PPO Family Low

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: NULL Tier

Accepted Plan ID Variations

58609TX0010004

Dominion National

Choice PPO Basic

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CHOICE Tier

Accepted Plan ID Variations

23018TX0020001

Choice PPO Basic Kids

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CHOICE Tier

Accepted Plan ID Variations

23018TX0020005

Choice PPO Plus

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CHOICE Tier

Accepted Plan ID Variations

23018TX0020003

Choice PPO Premium

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CHOICE Tier

Accepted Plan ID Variations

23018TX0020002

Choice PPO Premium Kids

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CHOICE Tier

Accepted Plan ID Variations

23018TX0020006

Choice PPO Preventive

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CHOICE Tier

Accepted Plan ID Variations

23018TX0020004

Florida Combined Life

BlueDental Copayment Q

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ADVANTAGE-PLUS-NETWORK-IF-OUTSIDE-OF-FLORIDA Tier

Accepted Plan ID Variations

30115FL0010001

BlueDental Copayment QF

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: ADVANTAGE-PLUS-NETWORK-IF-OUTSIDE-OF-FLORIDA Tier

Accepted Plan ID Variations

30115FL0040001

Guardian

Guardian Basics for Families and Individuals

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CS--AETNA Tier

Accepted Plan ID Variations

12846TX0280005

Guardian Choice for Families and Individuals

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CS--AETNA Tier

Accepted Plan ID Variations

12846TX0290006

Guardian Essentials for Families and Individuals

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CS--AETNA Tier

Accepted Plan ID Variations

12846TX0270005

Guardian Preventive Plus for Families and Individuals

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: CS--AETNA Tier

Accepted Plan ID Variations

12846TX0300004

Humana

Humana Dental Smart Choice

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

44965LA059000191604WI0490002

Humana Dental Smart Choice - Basic

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

46958UT0470002

Humana Dental Smart Choice - High

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

15980FL016000423468OK020000230613MO056000331358HI001000232237NC029000244580AL038000346958UT048000148963MS051000363141TX076000266105AZ062000382120TN063000599791IN0540002

Humana Dental Smart Choice - Lite

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

15980FL016000523468OK020000330613MO056000232237NC029000344580AL038000463141TX076000382120TN0630006

Humana Dental Smart Choice - Low

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

15980FL016000323468OK020000130613MO056000131358HI001000132237NC029000144580AL038000148963MS051000262294MI042000163141TX076000166105AZ062000282120TN063000497596OH058000399791IN0540001

Renaissance Dental

Alabama Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28725AL0110002

Alabama Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28725AL0130002

Alabama Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28725AL0110001

Alabama Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28725AL0130001

Alabama Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28725AL0150001

Florida Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

48129FL0130004

Florida Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

48129FL0150004

Florida Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

48129FL0130003

Florida Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

48129FL0150003

Florida Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

48129FL0180001

High PPO Dental Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28419LA0040001

High PPO Dental Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28419LA0050001

Kansas Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

95038KS0040003

Kansas Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

95038KS0050002

Kansas Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

95038KS0070001

Low PPO Dental Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28419LA0040002

Low PPO Dental Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

28419LA0050002

Mississippi Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

84254MS0050003

Mississippi Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

84254MS0060002

Mississippi Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

84254MS0090001

Missouri Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

35853MO0040004

Missouri Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

35853MO0050004

Missouri Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

35853MO0040003

Missouri Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

35853MO0050003

Missouri Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

35853MO0070001

New Hampshire Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

72953NH0040002

New Hampshire Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

72953NH0060002

New Hampshire Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

72953NH0040001

New Hampshire Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

72953NH0060001

Oklahoma Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

13711OK0040003

Oklahoma Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

13711OK0050002

Oklahoma Wellness Essentials (On Exchange)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

13711OK0100001

South Carolina Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

97325SC0060004

South Carolina Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

97325SC0070004

South Carolina Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

97325SC0060003

South Carolina Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

97325SC0070003

South Carolina Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

97325SC0090001

Texas Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

40540TX0060005

Texas Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

40540TX0070004

Texas Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

40540TX0060003

Texas Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

40540TX0070003

Texas Wellness Essentials Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

40540TX0100001

Utah Preferred EPO Plan

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87169UT0070001

Utah Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87169UT0040004

Utah Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87169UT0050004

Utah Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87169UT0040003

Utah Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87169UT0050003

Utah Wellness Essential EPO Plan

EPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

87169UT0080001

Wisconsin Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

34210WI0040003

Wisconsin Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

34210WI0050002

Wisconsin Wellness Essentials

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

34210WI0070001

Wyoming Preferred Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

80132WY0040004

Wyoming Preferred Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

80132WY0050004

Wyoming Preferred Plus Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

80132WY0040003

Wyoming Preferred Plus Plan (Pediatric Only)

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

80132WY0050003

UnitedHealthcare

Lone Star - Smile Now

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

98809TX0690002

Smile Now Arizona - No Waiting Period PPO

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

82011AZ0110001

Smile Now Michigan - No Waiting Period PPO

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

63631MI0140001

Smile Now Ohio - No Waiting Period PPO

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

56726OH0080001

Smile Now Texas- No Waiting Period Plan

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

98809TX0690001

Smile Now Utah - No Waiting Period PPO

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

97462UT0100001

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does DR. ALEJANDRO MARTINEZ ALVARADO accept?

This provider accepts health insurance plans managed by the following insurance companies: Ambetter Health, Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan, Ambetter of Oklahoma, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, DentaQuest USA Insurance Company, Inc., Dominion National, Florida Combined Life, Guardian, Humana, Renaissance Dental, UnitedHealthcare. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

No, current public enrollment indicators show that this provider does not accept standard Medicare program assignments.

What managed care network types are accepted by this provider?

DR. ALEJANDRO MARTINEZ ALVARADO is enrolled across the following managed care network types: EPO, HMO, POS, PPO.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.
EPO (Exclusive Provider Organization): Restricts coverage strictly to network providers except for emergency situations, but generally allows seeking treatment from network specialists without an official referral.
POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.