Insurance guidance for planning your visit
Sunshine Rheumatology works with a broad range of insurance plans across all five locations. Patients often ask about Aetna, Blue Cross Blue Shield, Cigna, Humana, Medicare, and UnitedHealthcare, but network participation can change by product, so we recommend confirming your exact coverage details before scheduling.
Common carrier names patients ask us about
Patients often search for whether we work with Aetna, Blue Cross Blue Shield, Cigna, Humana, Medicare, or UnitedHealthcare. We do work with many major carriers in the Tampa Bay and Sarasota region, but we verify network status by the exact product on your card rather than the carrier name alone.
- Aetna
- Ambetter
- Blue Cross Blue Shield
- CarePlus
- Cigna
- Freedom
- Humana
- Humana Medicaid
- Medicare
- Optimum
- Oscar
- Sunshine Health
- UHC Dual
- UnitedHealthcare
- WellMed
This is not a complete list, and plan participation can vary by product type and location. If you do not see your plan mentioned, call the office at 813-333-5080 and we will confirm whether we are in network before you schedule.
Helpful reminders before scheduling or arriving
- Verify that Sunshine Rheumatology is in network with your specific insurance plan and product.
- Ask whether your plan requires a referral from your primary care doctor for specialty visits.
- Check whether prior authorization is needed for infusion therapy, imaging, or specialty medications.
- If you are unsure about coverage, contact the office before your appointment and our staff will help.
Understanding specialty visit costs
Seeing a specialist often involves different cost-sharing than a primary care visit. A few things to keep in mind before your appointment:
- Your specialist copay may be higher than your primary care copay
- Some plans require a referral from your PCP before the visit will be covered
- Prior authorization may be required for certain medications, infusions, or imaging
- Our office staff can help navigate authorization requirements when needed
Why the exact plan product matters
Two patients can have the same carrier name on their insurance cards and still have different network rules. Before you schedule, it helps to know whether your product is one of these common plan types:
- PPO or POS products that may allow self-referral
- HMO products that may require a referral from your primary care doctor
- Traditional Medicare
- Medicare Advantage products with their own network rules
- Medicaid or Medicaid managed-care products
- Employer-sponsored, retiree, or exchange plan products with limited specialist networks
We welcome Medicare patients across all five locations. If you have Medicare Advantage, Medicaid, or another government plan, call to confirm that your exact product is accepted before scheduling. For questions about cost, coverage, or what to expect with your plan, our billing team is available at billing@sunshinerheumatology.com.
Frequently asked questions
Do you accept Medicare?
Yes. We accept Medicare at all five locations. If you have a Medicare Advantage plan, please call the office to verify that your specific plan is in network.
Which insurance plans do you accept?
We work with many plans including Aetna, Ambetter, Blue Cross Blue Shield, CarePlus, Cigna, Freedom, Humana, Humana Medicaid, Medicare, Optimum, Oscar, Sunshine Health, UHC Dual, UnitedHealthcare, and WellMed. Network participation depends on the exact product and referral rules on your card, so call before scheduling and we will help verify the details.
What if my plan requires prior authorization for infusion therapy?
Our staff can help coordinate prior authorization with your insurance company before scheduling infusion appointments. This process can take several business days, so starting early helps avoid delays.
Can I be seen while waiting for insurance approval?
In some cases, yes. Contact the office to discuss your situation and we will help determine the best path forward based on your coverage status.
What if I do not have insurance?
If you have questions about cost or coverage options, call the office at 813-333-5080 and our team will help you explore available options.
Contact our billing team
For billing questions, claim inquiries, or help understanding your explanation of benefits, reach out to our billing team directly.
Billing inquiries: billing@sunshinerheumatology.com
General inquiries: 813-333-5080