Insurance Accepted at Total Foot & Ankle of Ohio

You are here

Home / Forms /

New Patient Form
In order to provide you the best possible care we need to gather some information from you. Please print and complete the form and bring them with you. It's important that you try to complete this before you arrive for your appointment.

Click to download (32kb)

Patient Referral Form
If you're looking to be referred from your current physician, please download the Patient Referral Form.
Click to download (177kb)

Online Patient Referral Form
Simply fill out our convenient online form by clicking here.

List of Contracted Insurance Plans for Total Foot & Ankle
Aetna – Group HMO	Health Networks of America
Aetna – Elect Choice EPO and EC Open Access	Humana Commercial HMO & PPO
Aetna – Golden Choice Medicare Plan (PPO)	Humana Choice – Medicare PPO
Aetna – Golden Medicare (HMO)	Humana Gold Choice Integrated Health Plan, Inc.
Aetna – Health Fund	Interplan Health Group (Direct Care America & Primary Health Services)
Aetna – HMO and Open Access HMO	Medicaid
Aetna – Managed Choice and MC Open Access	Medical Group of Ohio (MGO)
Aetna – Open Choice PPO	Medical Mutual (SuperMed/HMO Health Ohio)
Aetna – QPOS and Aetna Choice POS	Medicare
Aetna – Trad Choice Indemnity and National Advantage Program (NAP)	Medicare DME
Aetna US Access	Molina Health Care (Managed Medicaid)
Aetna Medicare Open Plan (PFFS)	Multi Plan
Anthem	Ohio Health Choice
Anthem – Senior Advantage	Ohio Health Group – Health Reach PPO
Anthem SmartValue (PFFS)	Ohio Health Group – Health Reach PRIME PPO
Beech Street	Ohio Preferred Network (OPN) PPO
BWC	OSU Managed Health Care Systems
Care Source (Managed Medicaid)	PROM/Flora
Central Benefits – No Contract	Prime Net
Choice Care Network/Humana	Railroad Medicare
Cigna – HMO & PPO	TriCare
Emerald Health Network PPO	Trinity Health Care (Mount Carmel Health Partners)
EverCare – Medicare HMO	United Health Care
First Health PPO	United Health Care – Medicare PFFS  United Health Care – Medicare Products
Great West (formerly One Health Plan) HMO/PPO	West Virginia W/C