Understanding Covered California

With the recent healthcare reforms and implementation of ObamaCare/Covered California, there has been a lot of confusion among patients regarding which doctors they are able to see. In California, the four major health plans that patients with Covered California can select are: Kaiser, Anthem Blue Cross, Blue Shield, and Health Net.

Patients who sign up for Kaiser will be managed directly by the Kaiser System. Patients who sign up for Anthem Blue Cross, Blue Shield, and Health Net will be able to see one of the contracted primary care doctors in the community who will refer them to a specialist within their network if needed.

Anthem Blue Cross
In Orange County, the Anthem Blue Cross Covered California plans are denoted as EPO plans. Currently, we do not have a contract with Anthem Blue Cross to see Covered California patients.

In the past year, HealthNet has closed contracting for new providers such as us. Thus, we do not a direct contract to see HealthNet patients. On the other hand, patients with HealthNet HMO plans who sign up with a medical group such as ADOC will be able to see us through a referral through ADOC.

BlueShied of California
We are contracted to see BlueShield patients with Covered Covering plans offered through small groups, which includes small businesses who offer their employees health plans.  We can generally see patients with policy numbers beginning with XET and XEW.

If you have any questions, please contact our office.

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