Insurance Accepted

Dignity Health Medical Group – Saint Francis/St. Mary’s contracts with a significant number health insurance plans and provides healthcare services that fit your health plan benefits. If you have questions about the health plans we accept, please contact us.

Dignity Health Medical Group – Saint Francis/St. Mary’s holds contracts with the following insurance plan providers:

Aetna

  • PPO
  • Elect Choice
  • Elect Choice EPO
  • Managed Choice
  • Open Choice PPO
  • Aetna Choice POS II (Meritain Health)
  • Medicare PPO

Anthem

  • PPO
  • Select PPO
  • Select PPO (PERS)
  • Covered California
    • PPO
    • EPO

Blue Shield

  • PPO
  • TRIO ACO HMO
  • Covered California
    • PPO
    • EPO

Brown & Toland Physicians

  • HMO Members

ChoiceCare*

  • PPO 

Coventry/First Health*

  • PPO

Health Net

  • PPO Individual & Family
  • PPO Small/Large Business
  • Primary EPO
  • PPO Centene Employee Plan
  • Select POS
  • Covered California
    • HSP – PureCare One Small Business
    • EPO PureCare One Individual & Family
    • PPO Small Business
    • EPO PureCare SHOP

HealthSmart*

  • PPO Preferred

Hill Physicians MG

  • HMO members

Managed Health Network (MHN)

  • Beh Health

Multiplan/PHCS*

  • PPO

Networks By Design*

  • PPO 

TriCare

  • TriCare (via Health Net)

United Healthcare

  • PPO
  • Heritage Select EPO
  • Medicare Advantage

(* denotes a NETWORK Plan, refer to the back of your insurance card for logo.)

GoHealth Service Only

  • Asian American Medical Group 
  • Canopy HMO Members 
  • Chinese Community Health Plan
  • JADE Medical Group MediCal

Types of Insurance Plans

Health Maintenance Organization (HMO)
An HMO plan generally provides comprehensive coverage by requiring members to receive services from a contracted health care provider.

As an HMO member, you must choose a Primary Care Physician (PCP) from one of the primary care specialties, such as Family Practice, Internal Medicine, or Pediatrics. Your PCP will coordinate your health care and refer you to specialists if medically necessary.

The HMO will prepay the Participating Medical Group (PMG) for your membership and health care each month. You may be responsible for copays, deductibles and non-covered services.

Usually, referrals are made primarily within the medical group. However, a new not-for-profit HMO, Western Health Advantage, allows you to seek any medically necessary specialty care from any specialist who practices within its network of four medical groups: Mercy Medical Group/Mercy, Woodland Healthcare, UC Davis and the North Bay Healthcare System. This feature gives members much more freedom of choice when specialty care is really needed.

Point of Service Plans (POS)
A POS plan allows the member to choose to receive a service from their Participating Medical Group (PMG) or from a non-participating provider, with two different corresponding benefit levels. HMOs offer some POS plans in addition to or in place of their regular HMO plans, with limited or expanded service levels. Or, a Preferred Provider Organization (see below) may offer POS options as an additional benefit. Many versions of this type of benefit exist and some employers offer their employees the option of choosing from several of these plans.

Medicare Risk HMO Plans
Anyone who is eligible for Medicare may enroll in a Medicare HMO plan. These plans may offer the member more services than traditional Medicare, including periodic health evaluations, pharmacy benefits and hearing aids.

Preferred Provider Organization (PPO)
Insurance companies contract with medical groups and hospitals to provide medical services to PPO members for discounted rates. If you choose a PPO, you select a PCP from a preferred provider network in order to receive your benefits at the lowest cost. If you go "out of network," your fees (deductibles and copayments) may be much higher.

Indemnity Plans/"Fee for Service"
These plans allow you to choose your providers from any group or health care facility. You are responsible for a percentage of your health care costs, which may take the form of deductibles or reimbursements. One disadvantage of this type of traditional insurance is that it doesn't cover many preventive medicines and procedures, such as routine physicals.