Insurance Plans Accepted at Gonzaba Medical Group

Gonzaba Medical Group is dedicated to serving its community and helping patients find the insurance plans and resources they require. It is important to have an in-depth understanding of each approved payment and insurance accepted at Gonzaba Medical Group, so you can receive the best medical treatment available in San Antonio and the surrounding areas. We have gone to great lengths to be able to accept many healthcare coverage providers.

We accept a wide range of insurance plans in order to offer you with the best health care available. While these networks may not cover all medical costs, it does allow us to accept coverage for many medical services.

Medicare Plans accepted at Gonzaba Medical Group

Medicare Approved Payments
Medicare is a government-sponsored health insurance coverage offered for individuals aged 65 or older. Medicare also provides health insurance coverage for qualifying disabilities, and individuals who have end-stage renal disease.

Understanding Medicare Advantage and Costs
The program, like other forms of insurance, covers health services and hospitalization expenses. Medicaid has many various forms of coverage plans, each with a distinct description of what is and what is not covered in the Medicaid insurance plan.

  • Medicare A
  • Medicare B

How to Enroll for Medicare Coverage
You can enroll, modify, or discontinue a Medicare Health Plan or a Medicare Advantage Plan (Part C) with or without drug coverage during the times listed below:

  1. Period of Initial Enrollment: You can join a plan when you first become eligible for Medicare.
  2. The Open Enrollment Period: You can enroll, change, or drop a plan from October 15 to December 7 each year. The first day of your coverage will begin on January 1st if the application is received by December 7th.
  3. The Open Enrollment Period for Medicare Advantage: During January 1st through March 31 of each year, if you’re enrolled in a Medicare Advantage Plan, you could change to a new Medicare Advantage Plan or change to Original Medicare, as well as enroll in a completely separate prescription drug coverage plan.

Insurance Plans accepted at Gonzaba Medical Group

Amerigroup

  • Amerivantage Select (HMO)
  • Amerivantage Select Plus (HMO)
  • Amerivantage Classic (HMO)
  • Amerivantage Classic Plus (HMO)
  • Amerivantage Dual Secure (HMO D-SNP)
  • Amerivantage Dual Secure Plus (HMO D-SNP)
  • Amerivantage Dual Coordination (HMO D-SNP)
  • Amerivantage Dual Coordination Plus (HMO D-SNP)

Devoted Health

  • Devoted Health Core San Antonio (HMO)
  • Devoted Health Prime San Antonio (HMO)
  • Devoted BeWell San Antonio (HMO)

Humana

  • Humana Gold Plus (HMO)
  • Humana Gold Plus (HMO SNP)
  • Humana Gold Plus Diabetes and Heart (HMO C-SNP)

UnitedHealthcare

  • AARP Medicare Advantage (HMO)
  • AARP Medicare Advantage Patriot (HMO)
  • AARP, Medicare Advantage Secure Horizons (HMO)
  • UnitedHealthcare Dual Complete (HMO D-SNP)
  • UnitedHealthcare Chronic Complete (HMO C-SNP)

Please contact us at (210) 485-1073 for additional information about Medicare Advantage plans and any other concerns about payment. You may also visit Medicare.gov for further information on what your plan offers regarding medical treatment coverage, costs, and other benefits.

Patient Resources

How to change your Primary Care Physician (PCP)

  • Notify the Patient Advocates in the lobby/front desk area at your GMG clinic or call (210) 905-4606.
  • Call your health plan. The number is located on the back of your insurance ID card.

How to obtain a referral from your Primary Care Provider

  • Discuss the request with your PCP at your next visit.
  • Call (210) 921-3800 and let the Patient Services Representative know that you are calling to request a referral.
  • Call the Patient Advocates (210) 905-4606. They can help determine how and when to obtain referrals and authorizations for specific services.
  • Patient Advocates can also assist with pricing for specific services and help define the patient’s financial responsibility.

Find a Gonzaba Medical Group Contracted Specialist

  • GMG provides information to help members and prospective members identify network physicians and hospitals. The link below provides a searchable list.

GMG Preferred Provider Directory

  • Patient Advocates can provide the GMG Physician Directory / Hospital directory via print or telephonically.
  • Patient Advocates are available face-to-face at Main Clinic, Northwest Clinic, and Woodlawn Clinics Monday – Friday 8 AM – 5 PM. Or reach out to them for assistance by telephone (210) 905-4606.
  • After hours, please leave a Voice Mail. Messages will be returned the next business day.

Provider Resources

How to obtain UM criteria and or find a GMG Contracted Specialist
Click here to find a Gonzaba Medical Group Specialist. To obtain UM Criteria please call GMG referral department at (210) 921-3801, Monday- Friday 8AM- 5 PM. Information can be provided over the phone, via fax, email, or US mail.

Please be prepared to provide the following:

  • Patient’s name
  • Patient’s date of birth
  • The service description
  • The date of the service or date of the request for service

Click here to view the Provider Manual.

IMPORTANT AFFIRMATIVE STATEMENT

Notice for all patient Managed Care Providers/ Practitioners
& Employees who make UM decisions

Gonzaba Medical Group affirms the following:

  • UM decision making is based only on appropriateness of care and service and existence of coverage
  • The organization does not specifically reward practitioners or other individuals for issuing denials of coverage
  • Financial incentives for UM decision makers to not encourage decisions that result in underutilization
IMPARTIALITY STATEMENT – PRACTITIONERS / PROVIDERS

Gonzaba Medical Group makes this Impartiality Statement that practitioners are ensured independence and impartiality in making referral decisions with no impact on:

  1.  Hiring
  2.  Compensation
  3.  Termination
  4.  Promotion
  5.  Any other similar matters