Accepted health plans and networks (2024)

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Accepted health plans and networks (3)Ver página en Español

We accept new patients with many different types of health insurance plans.

Accepted health plans and networks (4)

Health maintenance organizations (HMO)

When you have an HMO insurance plan, you choose a medical network and a primary care doctor who oversee your care.

Accepted health plans and networks (5)

Preferred provider organization (PPO)

When you have a PPO insurance plan, you can see a larger network of doctors for your care without a referral.

Accepted health plans and networks (6)

Medicare plans

We accept most Medicare plans, including Original Medicare, Medicare supplement and Medicare Advantage.

If you're under age 65 and have a family or individual plan

HMOs and point-of-service (POS) plans

A point-of-service plan (POS) is a type of managed care plan that is a hybrid of HMO and PPO plans.

Aetna

Anthem Blue Cross

Blue Shield3

Cigna

Health Net

Scripps5

Sharp Health Plan5

UnitedHealthcare®

Covered California

The state’s marketplace for Affordable Care Act plans.
Learn more

Ambetter from Health Net

Blue Shield HMO and PPO

LA Care6

Medi-Cal plan (California’s Medicaid program)

CalOptima Medi-Cal1

HealthNet1

IEHP1

LA Care6

If you're eligible for or already on Medicare

Special needs plans

This is for those on Medicare who have chronic or ongoing illnesses.

Health Net
(Cardiovascular disorders, chronic heart failure, diabetes)

SCAN Health Plan
(Diabetes mellitus)

Medicare Advantage D-SNP plans

This is for those who qualify for both Medicare and Medi-Cal, California’s Medicaid program.

Anthem

Blue Shield

Brand New Day1

CalOptima OneCareConnect1,2

Central Health Plan1

Health Net4

Inland Empire Health Plan

LA Care6

Molina
(limited network for LA County)1

SCAN Health Plan

WellCare1

Accepted health plans and networks (7)

Don’t see your plan?

If you aren’t sure what type of health insurance plan you have, check your health insurance card. If you can’t find the information there, you can:

  • Call your chosen Optum clinic to see if it accepts your health plan
  • Call your health insurance company to find out if you can see an Optum doctor
  • Visit Covered California to learn more aboutyour state’s marketplace

FAQ

There are several differences between a health maintenance organization (HMO) and preferred provider organization (PPO) plan. They differ in the size of the plan network, ability to see specialists, plan costs and coverage for out-of-network services. Also:

  • HMOs:
    • Coordinate your care through a network of doctors and hospitals. You pick a medical network and one primary care doctor within that network.
    • Your primary care doctor coordinates your care and works closely with the hospitals, specialists and other providers in your medical network.
    • Your HMO plan usually won't pay for any visits to health care providers who are not in your medical network.
  • PPOs:
    • Have a larger network of medical providers. This gives PPO patients more flexibility in choosing doctors.
    • You don’t have to select a primary care doctor. You can go to any health care professional you want without a referral — inside or outside of your network.
    • There are network benefits and out-of-network benefits. If you stay inside your PPO network, you’ll pay less for your medical services. If you go outside of your PPO network, you might have to pay more.

No. Optum isn’t an insurance plan. We’re a group of doctors who contract with most major health insurance plans. These include HMOs, PPOs, Original Medicare, Medicare Advantage and supplement plans. These may vary by office location.

Call the office you want to go to and see if it accepts your health plan. You can also call your health plan and ask if you can choose an Optum doctor.

Your insurance plan may require a copayment at your doctor's visit. We accept automatic bill pay, checks, Visa, American Express, Discover and Mastercard.

Please note, we no longer accept cash except at our urgent care locations. Our goal with our decision to no longer accept cash is to make your visit with us more efficient and enjoyable, from when you check in to when you check out.

Find care near you

Find care

Footnotes

  1. Limited network
  2. Health plan only offers dual eligible/Cal MediConnect option(s) for Medicare Advantage patients. Does not offer Medicare Advantage-only option(s).
  3. Employer-sponsored plans only
  4. Available in Orange County only
  5. Available in San Diego only
  6. Available in LA County only

If you’re uninsured or a self-pay patient, you have the right to ask for a good faith estimate of expected charges before getting services.

We guide utilization management decisions about care on our policies. We do not reward health care professionals for denying coverage or care. We also do not reward decisions that lead to underusing care. You or someone you have said can speak for you can request a copy of our utilization management policies by calling 1-877-267-8861, TTY711.

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Accepted health plans and networks (2024)

FAQs

What are networks in health insurance? ›

A provider network is a list of doctors, other health care providers, and hospitals that a plan contracts with to provide medical care to its members. They're known as “network providers” or “in-network providers.” A provider that isn't contracted with the plan is called an “out-of-network provider.”

Who are the top 5 health insurance companies? ›

The five largest health insurance companies are UnitedHealth Group, Anthem, Kaiser Permanente, Ambetter and Humana. Currently insured?

What does it mean to accept out of network insurance? ›

Providers that are out-of-network are those that do not participate in that health plan's network. The provider is not contracted with the health insurance plan to accepted negotiated rates. This mean that patients will typically pay more or the full amount for the service they receive.

What is the best health insurance in New Jersey? ›

Aetna and UnitedHealthcare are the best health insurance companies in New Jersey. Both companies have cheap average rates, good quality plans and good customer satisfaction.

What is meant by health network? ›

A network is a group of physicians, hospitals, and other healthcare providers that have contracted with a health plan for negotiated reimbursem*nt rates on medical services to the plan's enrollees. Healthcare providers participating in the network are sometimes referred to as “in-network” providers.

What is a network provider? ›

A network service provider (NSP) is a company that owns, operates and sells access to Internet backbone infrastructure and services. The primary customers of NSPs are other service providers, including internet service providers (ISPs), which, in turn, sell internet access to businesses and consumers.

When a PPO insured goes out-of-network? ›

With a PPO, you can go to a doctor or hospital that is not on the preferred provider list. This is called going out-of-network. However, you pay more to go out-of-network. The PPO pays less or nothing at all.

What's the disadvantage of going to an out-of-network provider? ›

Many health plans list an amount that is the most they'll pay for a certain service received out-of-network. If the doctor or facility charges more than your plan is willing to pay, you could be responsible for paying the difference in addition to your deductible, copay, and/or coinsurance.

What is the difference between out-of-network and non participating? ›

Non-participating providers, sometimes referred to as “out-of-network” providers, do not have formal contracts with any particular insurance network, in contrast to participating providers. Rather, they are autonomous entities that set their own prices for healthcare services.

What is the best healthcare in NJ? ›

These are the best hospitals in New Jersey, according to a magazine ranking
  • Morristown Medical Center.
  • Overlook Medical Center- Summit.
  • Englewood Hospital.
  • The Valley Hospital- Paramus.
  • Hackensack Meridian Health Hackensack University Medical Center.
  • Robert Wood Johnson University Hospital New Brunswick.
May 13, 2024

Which company gives best health insurance? ›

List of 10 Best Health Insurance Companies in India 2024
Insurance CompanyClaim Settlement Ratio for FY (2021-22)Incurred Claims Ratio (2023)
HDFC ERGO Health Insurance98.49%79.04
ICICI Lombard Health Insurance97.07%77.33
Aditya Birla Health Insurance99.41%64.48
ManipalCigna Health Insurance99.90%64.66
6 more rows

What is the best HMO for NJ FamilyCare? ›

According to the NJ FamilyCare/Medicaid “HMO Performance Report” released last month, Horizon NJ Health received a 92% overall performance score, the highest of all New Jersey's Medicaid managed care plans and the only plan to improve its overall score from previous reports.

What does network mean when it comes to insurance? ›

What does in-network mean? In-network refers to a health care provider that has a contract with your health plan to provide health care services to its plan members at a pre-negotiated rate. Because of this relationship, you pay a lower cost-sharing when you receive services from an in-network doctor.

What does it mean to have network coverage? ›

Glossary. The geographical area covered by the network of a service provider. Within this area, the phone will be able to complete a call using the carrier's network or a partner network.

What does network mean in HMO? ›

HMO Network

Like a PPO plan, an HMO plan has a network of doctors and hospitals that you can use. However, HMO networks are usually smaller than PPO networks. Providers in these “narrow” networks agree to accept lower payments in exchange for access to patients in the insurer's network.

What are networks in public health? ›

Networking involves making contacts and building relationships with people who work in the field of public health. The purpose of networking is to gather information to focus your job search, seek advice, expand awareness, gain exposure to the job market, and generate referrals.

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