Health Insurance Plans

Stanford Health Care (SHC) contracts with various Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO).

SHC participates in government programs such as Medicare, Medi-Cal, and TriCare.

2015 Covered California FAQs

2016 Covered California FAQs - COMING SOON

For enrollment questions about Covered California please visit their website or call 1-800-300-1506.

Always check with your health plan to confirm participation. For assistance choosing a physician, please call the Stanford Consumer Referral line at 1-800-756-9000. Click the health plan name below to visit their website.

Active for Calendar Year 2016 (Group Plans) 

Aetna
HMO (referral only), PPO, POS & EPO

Anthem Blue Cross 
HMO (referral only), PPO & EPO

Blue Shield of California
HMO (referral only), PPO, & POS

CIGNA 
*HMO, PPO, POS & OAP

Health Net
HMO (referral only), PPO, POS & EPO

HealthSmart (formerly Interplan) 
PPO, EPO & POS

Multiplan/PHCS/Beech Street 
PPO

United Health Care
HMO (referral only), POS, PPO & EPO

*Cigna HMO members may choose to select Stanford Health Care physicians as their primary care physician (PCP).

Individual and Covered California Plans Active for Calendar Year 2016

We are contracted and in-network with the following individual plans available for purchase directly from health plans or through the Covered California Exchange

Anthem Blue Cross
PPO, EPO, and HMO: Hospital services only, all physician services are out of network.

Cigna (Not available for purchase through Covered California)
PPO: Includes hospital and physician services in-network.

Health Net
EPO and PPO: Includes hospital and physician services in-network.

United Health Care
PPO and EPO: Hospital services only, all physician services are out of network.

Valley Health 
HMO: Includes hospital and physician services in-network for specialty services only.

Please contact your health plan directly to confirm your eligibility

If you have any questions please contact the Managed Care Department at 650-724-1460 or at managedcare@stanfordhealthcare.org.

During high volume call times during the year, such as the Open Enrollment period, it is advised to email your question, as it will be answered more quickly.

Other helpful Web sites for information on health insurance and managed care are:

Health insurance glossary

EPO (Exclusive Provider Network)

A type of health insurance plan that, like an HMO, limits health coverage to doctors and hospitals within the network. However, EPOs also provide options for patients to see specialists outside of the network.

HMO (Health Maintenance Organization)

A type of health insurance plan that limits health coverage to doctors and specialists who work for the organization. HMOs provide an integrated approach to health care, often with an emphasis on prevention.

OAP (Open Access Point of Service Plan)

A type of flexible health insurance plan that offers in-network referrals from your primary care doctor, as with an HMO. Additionally, patients can self-refer to specialists and facilisties within the network at a discount, or receive care at out-of-network prvoiders at a higher cost.

POS (Point of Service)

A type of of health insurance plan that charges less if you use doctors, hospitals, or providers within the plan's network. These plans require a referral from your primary care doctor to see a medical specialist.

PPO (Preferred Provider Organization)

A type of health insurance plan consisting of a network of hospitals and doctors. Health care received outside of the network can be covered at an additional cost.