Insurance

We accept most major HMO and PPO insurances, including Medicare, and all forms of Tricare. We also offer significant discounts to cash-paying patients.

Contracted Insurance List:

AETNA PPO
ALIGNMENT PPO & HMO
ANTHEM BLUE CROSS BLUE SHIELD PPO
BLUE CROSS PPO
BLUE SHIELD OF CA PPO
CHAMPVA
CIGNA PPO & HMO
COMMUNITY HEALTH GROUP (AS A SECONDARY INSURANCE)
FEDERAL BLUE CROSS
GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION (GEHA)
GREATIER TRI-CITIES MEDICAL GROUP (HMO)
GRAYBILL MEDICAL GROUP {SHARP} (HMO)
HUMANA PPO & HMO
HEALTHNET PPO & HMO

HEALTHNET COMMUNITY CARE HMO
MEDICARE (TRADITIONAL)
MEDICARE ADVANTAGE PLANS
MEDI-CAL (AS A SECONDARY INSURANCE)
MOLINA HMO
PROSPECT MEDICAL GROUP (HMO)
REGAL MEDICAL GROUP (HMO)
SCRIPPS HEALTH PLAN
SCAN (HMO)
TRICARE FOR LIFE (AS A SECONDARY INSURANCE)
TRICARE PRIME ACTIVE DUTY
TRICARE SELECT
UNITED HEALTHCARE PPO & HMO

Guide to Understanding your Bill and Out of Pocket Expenses:

Understanding your health insurance coverage can often be confusing. Here is a simple guide in understanding some of the most common health insurance lingo which can often help you understand your medical bill, explanation of benefits (EOB), and out of pocket costs.

An out-of-pocket medical expense is the amount a policyholder pays for a service or item their health insurance plan doesn’t cover. In many cases, these expenses will count toward your plan’s out-of-pocket maximum.

If you have a medical bill that includes an out-of-pocket expense, you’ll be responsible for paying the cost on your own. Depending on your plan and the care you receive, you could pay between 10% and 100% of the total cost of the item or service.

Even though you pay for your monthly health insurance premium on your own, your insurer doesn’t consider that payment an out-of-pocket cost. You must pay your premium to maintain active coverage, regardless of whether you access medical care. Your premium also doesn’t count toward your out-of-pocket limit.

Here are some common out of pocket expenses:

Deductible:

A deductible is the amount of money you must pay out-of-pocket before your insurance company will start to cover your medical costs. Until you reach your deductible, you’re responsible for paying a certain amount of your healthcare expenses without the help of your insurer.

Your health plan will outline your annual deductible. The amount will vary depending on your coverage’s metallic tier, health insurance company, and plan type. For example, the minimum annual deductible for a high deductible health plan (HDHP) in 2025 is $1,650 for individual coverage and $3,300 for family coverage¹.

Co-insurance

Coinsurance is the percentage of costs you must pay for covered care after you meet your deductible. Your insurer tracks how much you’ve paid toward your deductible throughout the plan year. They’ll send you an explanation of benefits (EOB) after you receive medical care to let you know how much you’ve paid so far.

If you’ve already met your deductible, your EOB will show how much coinsurance you owe. Coinsurance rates are a fixed ratio. So, you’ll pay the same percentage on a covered health expense every time.

Co-payment

A copay is a fixed amount of money you must pay for a covered service at the time of purchase. Both individual health plans and group health insurance policies can both have copays.

Several factors can affect how much your copay might be for a particular service or item, such as your chosen health plan, provider network, type of medical care, and more. But ultimately, your insurer predetermines your copay amount for services and items. Even if you’ve met your deductible, your plan may still charge you a flat copay for certain medical care.

Copays typically varies between primary care (PCP), Specialists, Urgent Care, and Emergency Room visits.

If you have received a bill, and have further questions, don’t hesitate to call our office to speak to one of our front office representatives. Call (760) 630-9200

Insurance

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