What Medicare Advantage, Medi Gap, Employer, Individual & Medi Cal Plans is Cedar’s Sinai,
UCLA Health Care Partners – Optum, THIPA Torrance Memorial IPA, or Stanford In Network for?
Medicare A & B & Medi Gap Plans
What Health Insurance is Accepted by Cedars Sinai
Cedar’s Sinai accepts Traditional or original Medicare (Part A and/or B), including Medicare supplement insurance (Medigap) plans, you will have coverage for care from Cedars-Sinai Medical Center, Marina Del Rey Hospital and many of our doctors.
Medicare Advantage (Part C) Cedars Sinai *
Medicare Advantage or a Medicare Health plan, is purchased from a private insurance company and typically organized like an HMO or PPO insurance plan.
Cedars-Sinai participates Plans Accepted in the following Medicare Health #Advantage plans:
- Alignment Health Plan
- AVA (PPO) 007
- Anthem Blue Cross of California
- Blue Shield of California (HMO)
- UnitedHealthcare
- If you enroll in an HMO plan, you must choose a primary care doctor in either the Cedars-Sinai Medical Group or Cedars-Sinai Health Associates HMO provider networks and be referred to specialists within these groups.
- Get more information on how to enroll, premiums, co pays, benefits
We can help you enroll, no extra charge for our services.
Email us [email protected] to verify the plans or use the provider finders on our Blue Shield and Blue Cross pages For UHC Get more information , we can help you enroll, no additional charge.
Of course, with a Medi Gap plan, you can go to ANY MD or hospital that accepts Medicare. Double check here, by using the tool on your right.
Cedars Sinai Insurances Accepted for:
Below are the Links to our #web pages for Plans we can consult & enroll you in!
- Employer Plans? (Per Cedar’s Website)
- Aetna Employer Group Coverage
- Blue Cross – Anthem – Employer Plans
- Blue Shield – Employer Group
- California Choice – Multiple Companies ONE Bill
- Health Net
- Kaiser Permanente – New Enrollment – Administrative
- Oscar
- Sharp Health Plan
- SHOP – Covered CA for Small Business
- Sutter Employer Health Plans 2022
- United Health Plan UHC
- Individual Plans? (Per Cedar’s Website)
- Blue Shield PPO
- Oscar – NOT Covered CA – Circle Network
- Medi Cal? (Per Cedars’s Website)
- Our webpage on picking a Medi Cal HMO
- Care to financially needy patients LA Times 1.2.2020 *
- Medi Cal Managed Care Find a Provider
- Our webpage on picking a Medi Cal HMO
- Out of USA Plans? (Per Cedar’s Website)
How to go about #Picking a HMO or PPO Primary Care Physician PCP – MD
PPO members for all Covered CA plans and maybe all? plans will now have a central point of contact PCP – Primary Care Physician, in the health system for receiving long-term, comprehensive, coordinated care for most health needs. PPO members are able to switch PCPs at any time. There is no action for members to take. Blue Shield will provide additional details on this new feature in the coming weeks.
Members of non-grandfathered PPO plans will continue to have the freedom to choose specialists and other providers – without referrals inside or outside the network – as they do now.
- PPO Primary Care MD – member communication from Covered California
- HHS offering $1 million to strengthen link between primary care and health equity
FAQ’s
- What is a primary care physician?
- Why is it important to have a PCP?
- How did we select your PCP match?
- When will I receive information about the PCP that I was matched with?
- I’ve been matched with a PCP. Now what?
- What should I consider when evaluating my PCP?
- How do I change my PCP?
- I already have a doctor that I like. How do I know if my preferred PCP is part of my plan’s network?
- I can’t find my preferred PCP in the Exclusive PPO Network. What do I do now?
- Will my PCP appear on my ID card?
- What happens if I make a change to my PCP?
- How often can I change my PCP?
- Provider Finder
- Primary Care & PPO VIDEO
- Understanding your plan VIDEO
- chcf.org/primary-care-matters * More readable summary * Health care systems with strong levels of primary care investment have better and more equitable health outcomes, lower care costs, and better care quality. We can build a healthier future for all Californians by focusing resources back to patients and their relationship with primary care providers.
- 7 tips for choosing a primary care doctor UHC
- Cedar's Sinai Provider Finder
Find Medicare Doctors who accept assignment #MD
- Our Webpage on Medicare Assignment – Doctor Participating or Not?
- Compare Hospitals - Search Medicare.gov
- Medicare Guide to Choosing a Hospital Publication # 10181
- Hospital Readmission Penalty Look Up
- Long-Term Acute Care Hospital (LTACH) Clinical Guidelines - Oscar
- US News & World Report America's Best Hospitals
- UCLA #3
- Cedar's Sinai # 6
- UCSF San Francisco #9
- Stanford #12
Blue Shield of California
Provider #Finder -
Dentists, Doctors & Hospitals
All Plans - Medicare Advantage, Employer Group, Under 65 - Covered CA
Find a doctor near you
VIDEOS
- Blue Shield Exclusive PPO Your new ppo * PPO Primary MD FAQ’s * has 50k+ doctors and 320 hospitals statewide, plus Blue Card benefits out of state & country. 2020 Agent Guide * Member Outreach Bulletin *
- How to use the Finding a provider tool above VIDEO
- Understanding Your Plan pdf
- Nurse Help 24/7, Heal and Teladoc save on prescriptions ER vs. urgent care.
- Use your online account to review claims, copays or deductibles and take advantage of other member benefits.
- Explanatory VIDEOS on everything... from Blue Shield
- chcf.org/primary-care-matters * More readable summary * Health care systems with strong levels of primary care investment have better and more equitable health outcomes, lower care costs, and better care quality. We can build a healthier future for all Californians by focusing resources back to patients and their relationship with primary care providers.
- Medicare Advantage Provider Print Directories BROKER ONLY
- Enroll and get full details on our
What Medicare Advantage Plan can I get that #UCLA will Accept?
UCLA Medical Center
UCLA’s Insurance’s Accepted webpage!
Medicare Advantage HMOs:
- HMOs:
- PPOs:
Individual & Family Plans UCLA Webpage
Blue Shield Exclusive PPO Provider Finder
Employer Group Plans
- HMO insurance and POS insurance
- PPO insurance
- Aetna
- Anthem Blue Cross
- Blue Shield of California
- Centivo
- Cigna
- Oscar offers Oscar EPO – Circle – CHOICE Network for small businesses
-
CIGNA + Oscar for Small Biz
- First Health
- Health Net of California
- Interplan (part of HealthSmart)
- MultiPlan
- UFCM Health System, Inc., doing business as California Foundation for Medical Care (CFMC)
- Prime Health Services
- Private Healthcare Systems (PHCS)
- TRICARE
- United Health care
- Please call the UCLA Health referral line at 310-825-2631 or your health plan for the latest updates on which insurance plan networks UCLA hospitals and physicians participate.
- ucla health.org/price-transparency
UCLA Health doctors and differences in accepted health insurance*
Certain UCLA Health doctors may not accept the same insurance plans that our hospitals do. (Find a provider at UCLA Health.)
Please call the UCLA Health referral line at 800-UCLA-MD1 (800-825-2631) for the latest updates on which insurance a particular doctor may accept.
Blue Cross Removes UC Hospitals From EPO Health Plans
UC Davis Medical Center, UC San Francisco Medical Center and Children’s Hospital, along with Benioff Children’s Hospital in Oakland are no longer part of their Pathway EPO network as January 1, 2022 Learn More – Insure Me Kevin.com
Steve explains how to navigate the UCLA Section
Sound will be fixed soon
FAQ’s
What are the co-pays in the UCLA and Cedars-Sinai medicare Advantage programs?
I am on SCAN currently and it’s not meeting my needs.
I want a low cost supplemental plan that covers me for the UCLA medical group.
Oct 15th is when my plan expires.
When you say supplement, I presume you mean Medi Gap, where you can go to any doctor or facility that accepts Medicare, right? All Medi Gap plans would pay for UCLA.
If I understand you correctly, your plan with SCAN expires 12.31.2019. October 15th is when you can pick a new Medicare Advantage plan.
See menu above for our page for Blue Cross Medi Gap and Blue Shield Medi Gap, rates & benefits are there. Email us for UHC information
Click here to get quotes for Medi Gap Plans
If so how do I find a Doctor .
I can pay for what Medicare doesn’t cover
UCLA confirms on their website ucla health.org/health-plans that they accept Medicare Assignment
You can also use Medicare’s Provider Finder medicare.gov/physician compare/
If you’d like to have a Medi Gap plan to pay what Medicare doesn’t check our Blue Cross and Blue Shield pages, use menu above.
I am 70 years, one eye completely blind,
I was with AARP, till last December 2016,, but Beginning January 1, 2017 , they have dis enrolled me.
I make $855. From SSI Supplemental Security Income – Benefits and my husband who is enrolled with Kaiser gets $1045. Per month
This January I went to see my doctor and was surprised to be billed $495. Which is the 20 % That I need to pay….
Is there any place I can enroll for membership.
I’ll appreciate any advice
You have Medi-Cal don’t you as it’s automatic with SSI, right? So, that would allow Medi-Cal to pay the 20% wouldn’t it?
That might give you issues with Medi-Medi where Medi-Cal enrolls you in a Medicare Advantage plan themselves, but there are ways to get out of it.
If you do have Medi-Cal, that allows you to enroll in a Medicare Advantage Plan throughout the year, not just during Open Enrollment.
So, the questions are:
What Medicare Advantage plan did you want to enroll in?
…It appears SCAN is the only plan UCLA takes from looking at their website. I don’t represent SCAN but can refer you to a friendly agent who does.
Did you submit the bill to Medi-Cal?
Is UCLA a Medi-Cal provider?
We found out that you can also apply for UCLA doctors through the ACO program – also know as Medicare Shared Savings Plan (MSSP). Here’s a UCLA link for information:
uclahealth.org/aco
Thank you very much for posting. Here’s more on the Shared Savings Program from CMS.Gov Section 3022 of ACA I wonder how many people that want to repeal Obamacare even know this is part of it? Here’s information on Blue Shield’s ACO for under 65. Use the menu above and check out Medi-Gap – Supplement plans.
#Understanding Medicare Advantage Plans (PDF) #12026
Insurance Companies get a fee from the Federal Government, when you enroll in an MAPD plan. MAPD Plans must cover all A & B services Medicare.Gov *
That's why the premium is very low or ZERO!
- Set a phone or Skype Meeting
- We can now do SOC Scope of Appointment, before the Meeting via a 3 minute recorded meeting 2 days before. AHIP Training Module 4 Page 14 *
- #Intake Form - We can better prepare for the meeting
- HMO - Narrow Networks?
- Do I just sign up with a Medicare Advantage Company and automatically get * Parts A & B or do I have to get those from Medicare.Gov * VIDEO
- Get Quotes, Full Information and Enroll
- MANDATED wording!: Think Advisor * ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.’’
- We disagree with the above wording, as we can use the same tools on Medicare.gov as they do!
- FYI a 4.27.2022 HHS Office of the Inspector General report found that MAPD plans denied 13% of prior authorizations that would have been covered under original Medicare (Conversely, Medi Gap, just follows what Medicare pays.)
- 88% of MAPD enrollees are happy
-
MAPD plans often include Dental & Part D - Rx Prescriptions and often have NO premiums! How is that possible? The Federal Government pays them around $700/month to handle your medical care. You must continue to pay your Medicare Part B premium of about $170/month. It's best to apply when you turn 65 for the supplement plans or advantage plans, as that's the main "Open Enrollment" period, guaranteed issue for any plan.
-
Medicare Advantage Plans also have an annual open enrollment now known as AEP Annual Election Period October 7 to December 15th.
-
Additional Coverage is important as Medical Bills are increasing Seniors Credit Card Debt or leading to possible bankruptcy?
Health Care Partners – #OPTUM
MAPD Medicare Advantage Plans
Accepted & Available from Steve Shorr Insurance
- Blue Shield
- United Health Care Get more information
- See Optum Link above for plans that Steve Shorr Insurance doesn’t represent
Original Medicare Parts A – Hospital and B Doctor Visits and
Medicare Supplements – Medi Gap:
- Anthem Blue Cross
- Blue Shield
- United Health Care Get more information
Under 65 Individual Accepted Plans
On Optum Website
Covered California Plans
Generally same network as Direct or Off Exchange
- Health Net Employer Pure Care
- Health Net 2022 Pure Care
- LA Care – Medi Cal & Covered CA
- (LA County Only) Contract confirmed for ALL of 2021 12/15/2020 broker bulletin.
Blue Cross HMO
LA County ONLY
If you have any questions about the specific Insurance Company above, please ask on their webpage, use link above to go there.
Our Web pages for Carriers – Companies
Health Care Partners – Optum
Patient ONLINE Portal – POP
- View your lab test results
- Make appointments with your providers
- Request medication refills
- Send a secured message to your doctor’s office
- Register a loved one for a proxy account
- Pay your HealthCare Partners bill
- FAQ on changes from Davita & Health Care Partners to Optum
What Health Insurance, MAPD, Medi Gap Plans does
#THIPA Torrance Memorial IPA
take?
Accepted Health Plans
- Medicare Advantage Plans we represent
- THIPA Torrance Hospital Independent Physician Association
- SEARCH Find a Doctor
- Torrance Memorial Medical Center has again been recognized as a Best Hospital for 2019-20 for the 8th consecutive year, placing us in the top 3% in the state by U.S. News and World Report!
THIPA Flyers
Torrance Memorial IPA Brochure
COVID 19
- COVID 19 Information from Torrance Memorial
- Our Webpage on Insurance Company Bulletins for COVID 19
#Find a Anthem Blue Cross
Doctor, Physician, Dentist Hospital and other Providers
- Network Map Individual & Family Plans
- What plans do major providers accept?
- Cedar’s Sinai,
- UCLA
- Health Care Partners – Optum,
- THIPA Torrance Memorial IPA
-
Blue Cross Removes UC Hospitals From EPO Health Plans
UC Davis Medical Center, UC San Francisco Medical Center and Children’s Hospital, along with Benioff Children’s Hospital in Oakland are no longer part of their Pathway EPO network as January 1, 2022 Learn More - Insure Me Kevin.com
- Anthem Blue Cross Provider List Definitions Individual Plans
- Enroll with Blue Cross Anthem
- VIDEOS
- What to do when you receive a doctor bill VIDEO
- VIDEO When you're looking for health insurance in California, consider the quality of care provided by Anthem Blue Cross. The Anthem team knows the needs of growing families and offers an array of plans that offer affordable coverage for members of all ages.
- VIDEO What do do when you get a doctor's bill
- Live Health ONLINE - Tele Med with therapist VIDEO
- SYDNEY Overview VIDEO
- In & Out of Network - What's a network? HN Video
- Steve helps you find PCP VIDEO
#Stanford Health Care – Hospital takes these Insurance Plans
- stanford financial-assistance
- stanford health care.org/financial-assistance-policy
- Healthcare providers are prohibited by law from billing people with Medi-Cal for charges not covered by their insurance. LA Times
#Medicare10050 and You 2024
Everything you want to know
- Steve's Video Seminar Introduction to Medicare & You
- Audio from Medicare.Gov
- Clear View to Medicare Patient Advocate.org - 36 pages
***********
- Your Medicare #Benefits # 10116
- Don't like computers? Prefer a printed version be mailed to you? Audio MP 3
- Inpatient ONLY - How Medicare Pays for your Surgery Part A vs Part B Very Well Health.com
- medicare.gov/coverage
- Enroll in Blue Cross
- Learn about UHC United Health Care
- Enroll in Blue Shield
- Use our scheduler to Set a phone, Skype or Face to Face meeting
- TITLE XVIII—HEALTH INSURANCE FOR THE AGED - Medicare AND DISABLE
Blue Shield of California Authorized Agent - Broker
Medi Gap Plans from Anthem Blue Cross –
Click for Information and ONLINE enrollment
https://insuremekevin.com/cant-find-a-doctor-look-at-low-star-rated-docs/
https://patch.com/california/pleasanton/stanford-health-care-valleycare-named-among-best-us-hospitals-us-news
https://www.sandiegouniontribune.com/news/health/story/2022-07-26/ucsd-scripps-sharp-earn-national-rankings-in-latest-u-s-news-best-hospitals-report
https://www.dailynews.com/2022/07/26/cedars-sinai-is-2nd-in-nation-ucla-medical-center-tied-for-5th-in-us-news-hospital-rankings/
See our webpage on narrow lists and provider directory accuracy
https://individuals.healthreformquotes.com/aca/metal-levels/provider-finder/narrow-lists/
Having trouble figuring what insurance each physician accepts.
Help please
You might check with the doctor or his IPA Medical Groups website.
Then double check on the Insurance Companies Provider Finder.
Medicare
Blue Cross
Blue Shield
Our Quote Engines Provider Finder for ALL Companies
Covered CA also has a tool… but I personally don’t like it. It forces you to get a quote first and it doesn’t save…
See above on the website and below on our FAQ’s for details and video’s how to use each Insurance Companies provider finder.
If you are getting your coverage from us, just tell us what MD’s you want and we can research it for you.
I wanted to know if Cedars-Sinai Medical Group accepts Anthem Blue Cross.
We have been with our pediatrician for some time and I’d like to continue with her, Dr. Kyle Monk.
Do you have an, Medicare, Medicare Advantage, employer, individual plan or Medi-Cal with Blue Cross?
HMO or PPO?
Name of Plan & Networks?
Blue Cross Provider Finder
Cedars Lists of Accepted Insurance
Medicare Advantage
All Other Plans
Dr. Kyle Monks Cedars Profile
Please note, that just because an MD says they accept a plan, doesn’t mean that you can buy it!
I just was informed that my Health Net insurance coverage issued by Los Angeles Unified School District will not enable me to continue with the Cedars Sinai Medical Associates that I’ve been covered under.
Do you know if there is a way to continue this coverage using Anthem Blue Cross HMO or EPO with some type of supplemental insurance coverage that isn’t prohibitive cost wise?
Here’s information we have for CalSTRS and LAUSD Retirement Plans.
Blue Cross HMO & EPO are other options one can pick from on LAUSD Open Enrollment.
One would need to double check that Cedars Sinai is covered by those plans. You’ll find Blue Cross’s Provider Finder on my webpage here.
The first, initial response from LAUSD is that you can only change if you have a Major Life Event, due to IRS rules.
Major Life Events/Actions
• Begins/ends full-time employment
• Begins retirement
• Marriage, divorce or death of a spouse
• Birth or adoption
• Death of a covered child
• Spouse gains/or loses employer health plan eligibility
• Spouse loses employment
• Gains/loses eligibility for Medicare
• Employee/retiree or dependent moves in or out of plan’s service area
We might look into if you could qualify under SB 133 AB 369 Continuity of Care? Are you being treated for a chronic, acute or terminal illness? You may answer privately – email us at [email protected] or just reply below and don’t put in your name.
This might also qualify as a special enrollment into an individual plan? Group Plans might have something similar, I’d have to research.
Here’s the contact page for LAUSD benefits administration.