INSURANCES WE ACCEPT


PPOs

PPOs (Preferred Provider Organization) - are independent insurance policies through health plans, where you can choose in-network or out-of-network physicians anytime without requiring authorizations from a primary care doctor.

  • AETNA (PPO)

  • ANTHEM BLUE CROSS (PPO)

  • BLUE SHIELD (PPO)

  • HEALTH NET (PPO)

  • CIGNA (PPO)

  • UNITED HEALTHCARE (PPO)

HMOs (COMMERCIAL)

HMO (Health Maintenance Organization) - are health plans through physician networks, offered by the employer and assigned to a specific primary care physician. All specialist referrals require authorizations from the primary care doctor.

Contracted IPAs or PPGs are:

  • CITRUS VALLEY (IPA)

  • REGAL (IPA)

  • LAKESIDE (IPA)

  • OPTUM / Former HCP (IPA) 

COVERED CALIFORNIA

Covered California - is a state Exchange plan for those that don’t qualify for Medi-Cal, but have the option to purchase their health insurance, with the state paying a portion of their premium.

  • LA CARE (via IPA network)

    • Preferred IPA

    • CVPG IPA

    • Optum IPA,

  • HEALTH NET (via IPA network)

    • Regal,

    • Lakeside,

    • CVPG

    • Health Net (Direct)


STATE & FEDERAL


(STRAIGHT) “MEDI-CAL OR MEDICARE” - are Unenrolled Original Health Care Coverages of the State (Medi-Cal) and Federal (Medicare) levels, not enrolled into any network system or participating physician groups.

  1. Medi-Cal (Straight) is the “Medicaid of California”, providing health insurance by state to low-income patients.

  2. Medicare (Straight) is a federal program offered to elderly patients above 65 years, and individuals with work-related chronic disabilities after 2 years.

  3. Medi-Medi (Straight: Medicare + Medi-Cal), also known as Dual Eligible, has 100% coverage for (low incomes).


MEDI-CAL (HMO) - Medi-Cal enrolled into HMO, managed by Health Plans, assigns a Primary Care Provider (PCP) and Participating Physician Group (PPG), via Independent Physicians Associations (IPAs).

  • PREFERRED (IPA)

    • LA Care

    • Blue-Shield Promise

    • Anthem Blue Cross

    • Health Net

    • Molina

  • CITRUS-VALLEY (IPA)

    • La Care

    • Blue Cross

    • Health Net

  • REGAL & LAKESIDE (IPA)

    • Health Net

    • Molina


MEDICARE ADVENTAGE (Senior Plans) - are for retired patients who are not low income, and do not qualify for Medi-Cal.

  • Medicare Advantage (Senior Plan): has (100%) coverage within IPA network,

  • Has (80%) coverage without Medi-Cal.

  • If you Don’t qualify for Medi-Cal (20%), you may enroll into Senior Plan.

  • Call us to have our broker enroll you into Medicare Aventage (Senior plan).

Abbreviations:

  • Participating Physician Group (PPG),

  • Primary Care Provider (PCP)

  • IPA = Independent Physician Association

  • HMO = Health Maintenance Organization (access to doctors and hospitals within its network)

  • PPO = Preferred Provider Organization (provide flexibility when picking a doctor or hospital).

➤ HealthCare Coverages