It’s important to note that Doctors and hospitals do not work with all insurance plans. Check the provider search websites below to see if your preferred Doctor or Hospital is IN-Network (aka Contracted) before finalizing your plan choice. Preventive care services (i.e., annual physicals, well-woman, well-baby checkups, etc) are only covered at no charge with IN-Network providers. HMO plans do not provide any coverage for OUT-of-Network providers. PPO plans will only offer a partial reimbursement after a separate Out-of-Network deductible of $5,000 or more is met even if you have a plan that has no deductible for IN-Network providers. Therefore, we recommend using IN-Network doctors and hospitals whenever possible.
Sutter Health is IN-Network with the Anthem Blue Cross Pathway EPO Individual and Family plans. Below is the link to see the accepted health plans with Sutter Health.
www.sutterhealth.org/health-plan
Click below to download the
Anthem Blue Cross Mobile app that connects you to everything you need to know about your health plan.
www.anthem.com/member-resources/sydney-app
Earn rewards for healthy habits. Anthem’s Smart Rewards program lets you earn rewards for completing health and wellness activities. For example, you can make $25 for a physical exam or well-woman exam within the first 90 days of when your plan begins. Also, get $20 for taking a Health assessment via the Anthem Mobile App (Sydney Health). As you complete the activities, your plan is updated, and you can redeem rewards for a digital gift card from a selection of top retailers. Redeem rewards on anthem.com/ca or via the Anthem Sydney app.
Below is the link to search Anthem Blue Cross SELECT Drug Formulary to find out what Tier level your current prescriptions are.
www.anthem.com/ca/pharmacy-information/drug-list-formulary/
You can view a list of all the Preventive Care that is covered at no charge with Anthem Blue Cross at the website below.
www.anthem.com/preventive-care/
Anthem offers free telehealth (aka virtual care) under all non-HSA metal tier plans (Bronze, Silver, Gold & Platinum). Connect with a doctor any time of the day or night by phone video. Receive help with Mental Health,
Allergies, and non-emergency medical issues. You can even schedule appointments with specific doctors for ongoing treatment. Please visit the website below for more information on how to receive virtual care.
www.anthem.com/ca/virtual-care
Anthem EPO Members have “Full Access” for care, meaning they can use any provider within the U.S. or outside the country as long as they go to a Blue Card provider. Blue Card providers can be found by calling 800-810-2583 or
visiting the website below.
bcbs.com
Children under 19 automatically have Pediatric Dental & Vision coverage included under all Anthem medical plans. Find out what is covered by viewing the pdf below.
Anthem Pediatric Dental & Vision Benefits
Use the website below to find an Anthem Pediatric Dentist or call the Dental Prime department at (877) 567-1804.
www.anthem.com/DentalPrime
Use the website below to find an Anthem Pediatric Vision Care provider or call the Blue View Vision department at (866) 723- 0515.
www.anthem.com/BlueViewVision
Click below to download the
Anthem Blue Cross Mobile app that connects you to everything you need to know about your health plan.
www.anthem.com/member-resources/sydney-app
Earn rewards for healthy habits. Anthem’s Smart Rewards program lets you earn rewards for completing health and wellness activities. For example, you can make $25 for a physical exam or well-woman exam within the first 90 days of when your plan begins. As you complete the activities, your plan is updated, and you can redeem rewards for a digital gift card from a selection of top retailers. Redeem rewards on anthem.com/ca or via the Sydney app.
Anthem Members receive discounts for many services such as ancestry service kits, grocery store coupons for healthier foods, gym memberships, infertility treatment, glasses, LASIK, hearing exams, and more. Click below for a
list
of all the Anthem Member discounts that are offered.
List of Member Discounts
Below is the link to search Anthem Blue Cross SELECT Drug Formulary to find out what Tier level your current prescriptions are.
www.anthem.com/ca/pharmacy-information/drug-list-formulary/
You can view a list of all the Preventive Care that is covered at no charge with Anthem Blue Cross at the website below.
www.anthem.com/preventive-care/
Anthem offers free telehealth (aka virtual care) under all non-HSA metal tier plans (Bronze, Silver, Gold & Platinum). Connect with a doctor any time of the day or night by phone video. Receive help with Mental Health,
Allergies, and non-emergency medical issues. You can even schedule appointments with specific doctors for ongoing treatment. Please visit the website below for more information on how to receive virtual care.
www.anthem.com/ca/virtual-care
Anthem HMO Members only have coverage for Emergency or Urgent Care situations outside of their county of residence. In an Emergency or Urgent Care situation, they go to any Blue Card provider within the U.S. or outside the
country. Blue Card providers can be found by calling 800-810-2583 or visiting the website below.
bcbs.com
Children under 19 automatically have Pediatric Dental & Vision coverage included under all Anthem medical plans. Find out what is covered by viewing the pdf below.
Anthem Pediatric Dental & Vision Benefits
Use the website below to find an Anthem Pediatric Dentist or call the Dental Prime department at (877) 567-1804.
www.anthem.com/DentalPrime
Use the website below to find an Anthem Pediatric Vision Care provider or call the Blue View Vision department at (866) 723- 0515.
www.anthem.com/BlueViewVision
Visit the website below to find out everything you need to know about renewing your Blue Shield plan during the Open Enrollment.
www.blueshieldca.com/renewalcenter
You can find more information about how the Blue Shield Trio HMO plan works by visiting the website below.
www.blueshieldca.com/trio
Visit the website below to find out how to schedule an appointment and receive care with the Blue Shield Trio HMO plan.
www.blueshieldca.com/bsca/navigating-your-hmo
Below is the link to search Blue Shield Drug Formulary to find out what Tier level your current prescriptions are.
www.blueshieldca.com/pharmacy/formulary
Blue Shield Trio HMO members can join the Healthy Savings® program, which provides access to healthier foods for a reduced price at participating grocery stores. Click below to learn more.
www.blueshieldca.com/healthysavings
Blue Shield Trio HMO members have $0 copays for Teladoc, which provides access to board-certified doctors and pediatricians via phone or online video consultations. Click the link below to sign up for this service.
teladoc.com/bsc
Click below to understand what is covered as no charge under Preventive Care with Blue Shield:
www.blueshieldca.com/preventive-care
Blue Shield Mental Health Resources:
www.blueshieldca.com/en/home/be-well/live-healthy/mental-health-resources
Blue Shield Mental Health Network Search:
www.blueshieldca.com/find-a-provider
Choose your Benefit Plan: BSC Individual/Family Plan Network
You can also perform the search by phone at (877) 263-9952.
Blue Shield Acupuncture Provider Search:
https://www.ashlink.com/
You can also perform the search by phone at (800) 678-9133.
Preventive Guidelines for Children can be found below:
www.blueshieldca.com/childrenpreventivecare
Children under 19 automatically have Pediatric Dental & Vision coverage under all Blue Shield medical plans. The pediatric vision customer service number is (855) 342-9105. You can read more about how to use these coverages by clicking below.
www.blueshieldca.com/pediatricdentalandvision
First, select a plan year: 2025, enter your city
Second, add a filter: Select Filter by Plan/Network
Covered California: HMO - Ambetter HMO IFP*
*HMO PCP must be within 30 miles of Zipcode
Find a Pharmacy that accepts Health Net*:
ifp.healthnetcalifornia.com/pharmacy
*Walgreens is not a covered (i.e. IN-Network) pharmacy under the Ambetter HMO plan.
Health Net will add Providence in Orange County to its HMO network for 2025. Health Net will be the only HMO option with the Providence Health System in its network, which includes Mission Heritage, St. Joseph, and St. Jude.
Health Net’s Mental Health Network Search:
providers.mhn.com/member/practitionerSearch
Benefit Plan Selection: Other Health Net Plans (Health Net of California/Oregon/Arizona)
Other Health Net Plans: Health Net of California
Do you want to search for providers who accept a specific plan? Yes
Please select the plan from this list: Covered California - HMO - Ambetter IFP.
You can also perform a search by phone at (800) 227-1060
Below is the website to view Health Net’s list of Covered drugs.
www.healthnet.com/covereddrugs
My Health Pays is a rewards program that pays you for the healthy decisions you're most likely already making every day. Earn up to $422 in rewards per calendar year. Visit the Health Net website below for more details.
www.healthnet.com/myhealthpays
Health Net’ provides you with access to the wellness tools and resources you need to maximize your health via Sharecare. Visit the Health Net site below to get started.
www.healthnet.sharecare.com/
Children under 19 automatically have Pediatric Dental & Vision coverage included under all Health Net HMO & HSP medical plans. Pediatric Dental Services are administered by Dental Benefit Providers (DBP) - (866) 249-2382.
Pediatric Vision Services are administered by EyeMed - (866) 392-6058. You can read more about the level of coverage by downloading the pdf below.
or calling the
www.healthnet.com/pediatric_dental-vision.pdf
New Members: Visit the website below to find a care team, make your first appointment, and quickly access helpful coverage information.
www.kp.org/newmember
Below is the Kaiser website that explains how to get access to care. healthy.kaiserpermanente.org/get-care
Click below to download the
Kaiser Permamente Mobile app that connects you to everything you need to know about your health plan.
https://healthy.kaiserpermanente.org/colorado/pages/mobile-app
Click below to understand what is covered as no charge under Preventive Care with Kaiser: healthy.kaiserpermanente.org//preventive-services
Kaiser offers free telehealth (aka virtual care) under all non-HSA plans (Bronze, Silver, Gold & Platinum). All their virtual care (including mental health) is provided by a Kaiser Professional and is powered by the world’s largest Electronic Health Record. Please visit the website below for more information on how to receive virtual care. healthy.kaiserpermanente.org/virtualcare
Click below for information about how to access Mental Health Services through Kaiser Permanente.
healthy.kaiserpermanente.org/mental-health
The Ginger app offers immediate 1-on-1 support for coping with many common challenges — from stress and low mood to issues with work and relationships, and more. Ginger’s highly trained emotional support coaches are ready to help 24/7, and adult Kaiser Permanente members can use Ginger for 90 consecutive days at no cost.
Download the Ginger App
Whether you’re headed to a family vacation, a work conference, or college, Kaiser Permanente has you covered while you’re away from home. You can get urgent and emergency care anywhere in the world. And now, when you’re outside of a Kaiser Permanente state, you can visit any Cigna PPO Network provider, CVS MinuteClinics, and Concentra clinics without paying upfront or filing a claim for reimbursement. Visit the Kaiser website below for more information. healthy.kaiserpermanente.org/get-care/traveling
Get an idea of what care will cost: www.kp.org/treatmentestimates
Below is Kaiser’s website regarding COVID-19 coverage: healthy.kaiserpermanente.org/coronavirus
Below is the link to search Kaiser’s Drug Formulary to find out what Tier level your current prescriptions are
healthy.kaiserpermanente.org/formulary
Visit the website below to find out how to schedule an appointment and receive care with Kaiser Permanente. Make sure to update the region accordingly.
thrive.kaiserpermanente.org/make-an-appointment/
Pediatric Dental coverage from Delta Dental is included for children under 19 with any Kaiser Permanente medical plan. Visit the website below, call Kaiser at (800) 589-4618 or Delta Dental at (800) 835-2244 for more
information.
www.kp.org/health
Pediatric Vision coverage is included under all Kaiser Permanente medical plans for children under the age of 19. Visit the website below to book an eye exam or call Kaiser’s member services at 800-464-4000 for more
information.
www.kp2020.org
L.A. Care’s Member Services is available 24 hours, 7-days a week at (855) 270-2327.
As of February 1st, 2024, UCLA closed its doctor panels with LA Care. New members can no longer select a Primary Care Physician with UCLA. Current LA Care members will keep their UCLA doctor as long as their plan stays active. As of now, the Blue Shield PPO is the only option for newly insured individuals to gain access to UCLA.
Visit the website below to find out how to schedule an appointment and receive care with L.A. Care Covered.
www.lacare.org/members/getting-care/appointments
Get the care you need when you need it the most by visiting a MinuteClinic. These are walk-in medical clinics inside select CVS Pharmacy store locations nationwide. Visit the L.A. Care’s website below for more information on
how to
use this service.
www.lacare.org/minuteclinic
L.A. Care members have the option of getting care 24/7 virtually in non-emergency situations through Teladoc, the global leader in telemedicine. From anywhere at any time, you can reach a doctor 24/7 by secure video chat or
phone—often within 10 to 15 minutes—to get a diagnosis and treatment. L.A. Care covers telehealth for free. Find out how to schedule a virtual visit by visiting
this L.A. Care website:
www.lacare.org/members/telehealth
Below is the website to view L.A. Care’s List of Covered Drugs. The L.A. Care Covered Formulary under the Resources menu will list the Tier Level for your current prescriptions.
www.lacare.org/providers/pharmacy-services
Click below for information about L.A. Care Mental Health Services offered through Beacon Health Options. You can also call Beacon’s Behavioral Health Hotline at 1-877-344-2858 to get an appointment.
www.lacare.org/members/behavioral-health
L.A. Care’s Community Link helps you connect with community agencies for assistance with housing, food, bills, and lots more.
communitylink.lacare.org/
Children under 19 automatically have Pediatric Dental through Liberty Dental & Vision coverage through VSP included under all L.A. Care medical plans. You can read more about how to use this coverage by clicking below.
Pediatric Dental:
www.lacare.org/members/getting-care/dental-services
-Contact Liberty Dental at 1-888-700-5243
Pediatric Vision:
www.lacare.org/members/getting-care/vision
-Contact VSP at 1-800-877-7195
New Members: Visit the Molina Quick Start website below for the next steps to help you get started with your new plan.
www.molinamarketplace.com/marketplace/ca/en-us/quick-start
Visit the website below to log in to My Molina to make a payment, change your doctor, or request a new ID card.
www.molinamarketplace.com/members
Visit the website below to find out how to schedule an appointment and receive care with Molina Healthcare.
www.molinahealthcare.com/newmembers
Click below for information about how to access Mental Health Services through Molina Healthcare.
www.molinahealthcare.com/mental-health
Below is the website to view Molina’s List of Covered Drugs.
www.molinahealthcare.com/formulary
Click below to understand what is covered as no charge under Preventive Care with Molina Healthcare.
www.molinahealthcare.com/preventive
Molina’s 24 Hour Nurse Advice Line: 888-275-8750
www.molinahealthcare.com/nurseadvice
Molina Healthcare is pleased to offer Teladoc (Virtual Care) to all their members. Click below for more information.
www.molinamarketplace.com/virtualcare
Children under the age of 19 automatically have Pediatric Dental & Vision coverage included under all Molina Healthcare plans. You can read more about how to use this coverage by clicking the links below.
Pediatric Dental: www.molinahealthcare.com/pediatric-dental
Pediatric Vision: www.molinahealthcare.com/pediatric-vision.aspx
Molina’s Care Connections Program Provides no cost, convenient preventive care to all Molina Members. Please call 844-491-4763 to schedule an appointment. Monday-Friday: 5:00am-7:00pm & Saturday 5:00am to 5:00pm. Below are the
services they provide.
Visit the website below to compare the Premier & Performance SHARP provider networks in San Diego.
www.sharphealthplan.com/our-plans/individual-and-family-plans/compare-networks
View the pdf below for more information on SHARP’s provider network.
Sharp Health Plan Network
Click below to access SHARP’s Virtual Urgent Care, see wait times for an urgent care facility, or save your spot in line.
www.sharp.com/urgent-care-centers
Click below for information about how to access Mental Health Services through SHARP.
www.sharphealthplan.com/mental-health
Get the care you need when you need it the most by visiting a MinuteClinic. These are walk-in medical clinics inside select CVS Pharmacy store locations nationwide. Visit the SHARP website below for more information on how to
use this service.
www.sharphealthplan.com/minuteclinic
Below is the website regarding SHARP's COVID-19 coverage.
www.sharphealthplan.com/covid-19
With Sharp, you are covered for urgent care and emergency services outside the San Diego and Riverside county area. Learn more about the out-of-area care options at the link below
www.sharphealthplan.com/travel-out-of-area-coverage
Below is the website to view SHARP's List of Covered Drugs.
www.sharphealthplan.com/search-drug-list
Visit the website below to find out how to schedule an appointment and receive care with SHARP.
www.sharphealthplan.com/members/get-care
Click below to understand what is covered as no charge under Preventive Care with SHARP.
www.sharphealthplan.com/members/preventive-care
SHARP’s Best Health® is a wellness program designed to help you live a full, vibrant life. The program offers free Coaching and Support, Wellness Assessments, and fitness discounts. Find out more about Best Health® at the
website below.
www.sharphealthplan.com/wellness/best-health
Children under the age of 19 automatically have Pediatric Dental coverage through Premier Access Dental & Vision coverage through VSP included under all SHARP plans. Please contact Premier Access Dental at (888) 715-0760 and VSP at (855) 868-4561 for more information on to access these benefits.
Call Valley Health Plan’s member services at (888) 421-8444 for help with selecting your Primary Care Physician and receiving care in a timely fashion.
Click below for information on how to pay your monthly premium with Valley Health Plan. www.valleyhealthplan.org/new-payment-methods-vhp-members-sign-today
View the pdf below for more information on VHP’s provider network.
Valley Health Plan Network
Click below for information about how to access Mental Health Services through Valley Health Plan. www.valleyhealthplan.org/members/behavioral-health
Below is the website to view Valley Health Plan's List of Covered Drugs. www.valleyhealthplan.org/members/pharmacy
Valley Health Plan offers MDLIVE Telehealth benefits (Virtual Care) to all its members. Click below for more information. members.mdlive.com/vhp/
Valley Health Plan’s 24 Hour Nurse Advice Line: (855) 348-9119 www.valleyhealthplan.org/members/247-nurse-advice-line
Children under the age of 19 automatically have Pediatric Dental coverage through Liberty Dental & Vision coverage through VSP included under all Valley Health plans. Please contact Liberty Dental at (888) 703-6999 and VSP at (855) 868-4561 for more information on to access these benefits.
View the pdf below for more information on WHA’s provider network.
Western Health Advantage Network
Click below for information about how to access Mental Health Services through Western Health Advantage. www.westernhealth.com/mental-health/
WHA members have the option of getting care 24/7 virtually in non-emergency situations through Teladoc, the global leader in telemedicine. From anywhere at any time, you can reach a doctor 24/7 by secure video chat or phone—often within 10 to 15 minutes—to get a diagnosis and treatment. Western Health Advantage covers telehealth at the same copay that would apply to an in-person visit. Find out how to schedule a virtual visit by visiting this WHA website: www.westernhealth.com/virtual-visits/
Below is the website to view Western Health Advantage's List of Covered Drugs. www.westernhealth.com/pharmacy-information/
Visit the website below to find out how to schedule an appointment and receive care with Western Health Advantage. www.westernhealth.com/mywha/welcome
Find out how to connect with your doctor 24/7 by visiting the website below: www.westernhealth.com/connect-with-your-doctor/
Frequently Asked Questions for new members with Western Health Advantage can be found below. www.westernhealth.com/new-member-faqs
Click below to understand what is covered as no charge under Preventive Care with Western Health Advantage. www.westernhealth.com/preventive-health-guidelines
Children under the age of 19 automatically have Pediatric Dental & Vision coverage included under all Western Health Advantage plans. You can read more about how to use this coverage by clicking the links below.
Pediatric Dental:
www.westernhealth.com/pdfs/peddental
Pediatric Vision:
www.westernhealth.com/pdfs/pediatric-vision
Get the care you need when you need it the most by visiting a MinuteClinic. These are walk-in medical clinics inside select CVS Pharmacy store locations nationwide. Visit the website below for more information on how to use this service.
www.aetnacvshealth.com/minuteclinic.html
View the pdf below for more information on the Balance by CCHP provider network.
Balance by CCHP Network
Click below for information about the Balance by CCHP plans. www.cchphealthplan.com/family-shopping/
Below is the website to view the summary of benefits for the Balance by CCHP plans. www.cchphealthplan.com/plandetails
Learn more about the IEHP Covered CA plans by visiting their website below. www.iehp.org/en/browse-plans/covered-california
Visit the site below to create an online member account with IEHP. members.iehp.org/App/Account/Login
Blue Shield Mental Health Network Search:
www.blueshieldca.com/find-a-provider
Choose your Benefit Plan: BSC Individual/Family Plan Network
You can also perform the search by phone at (877) 263-9952.
Visit the website below to find out everything you need to know about renewing your Blue Shield plan during the Open Enrollment.
www.blueshieldca.com/renewalcenter
Below is the website regarding Blue Shield's COVID-19 coverage:
www.blueshieldca.com/coronavirus
Download Blue Shield’s mobile app for easy access to your ID card, finding an In-Network Doctor or Urgent Care facility, reviewing your claim history, viewing your plan benefits, and much more.
www.blueshieldca.com/mobile
Blue Shield PPO members have $0 copays for Teladoc, which provides access to board-certified doctors, pediatricians, licensed psychiatrist, psychologist, or counselor via phone or online video consultations. Click the link
below for more information about accessing this benefit.
blueshieldca.com/teladoc
Below is the link to search Blue Shield Drug Formulary to find out what Tier level your current prescriptions are.
www.blueshieldca.com/pharmacy/formulary/p
Click below to understand what is covered as no charge under Preventive Care with Blue Shield:
www.blueshieldca.com/preventive-care
Preventive Guidelines for Children can be found below:
www.blueshieldca.com/childrenpreventivecare
Children under 19 automatically have Pediatric Dental & Vision coverage included under all Blue Shield medical plans. You can read more about how to use this coverage by clicking below.
www.blueshieldca.com/pediatricdentalandvision
Health Net will add Providence in Orange County to its PPO network for 2025. The Providence Health System includes Mission Heritage, St. Joseph, and St. Jude.
Health Net’s Mental Health Network Search:
providers.mhn.com/member/practitionerSearch
Benefit Plan Selection: Other Health Net Plans (Health Net of California/Oregon/Arizona)
Other Health Net Plans: Health Net of California
Do you want to search for providers who accept a specific plan? Yes
Please select the plan from this list: Covered California - PPO Ambetter IFP.
Below is the website to view Health Net’s list of Covered drugs. www.healthnet.com/covereddrugs
My Health Pays is a rewards program that pays you for the healthy decisions you're most likely already making every day. Earn up to $422 in rewards per calendar year. Visit the Health Net website below for more details.
www.healthnet.com/myhealthpays
Health Net’ provides you with access to the wellness tools and resources you need to maximize your health via Sharecare. Visit the Health Net site below to get started.
www.healthnet.sharecare.com/
Children under the age of 19 automatically have Pediatric Dental & Vision coverage included under all Health Net medical plans. Pediatric Dental Services are administered by Dental Benefit Providers (DBP) - (866) 249-2382.
Pediatric Vision Services are administered by EyeMed - (866) 392-6058. You can read more about the level of coverage by downloading the pdf below.
www.healthnet.com/pediatric_dental-vision.pdf