Health Insurance

Dealing with health insurance and other benefits can be very confusing. If you have questions, please call your insurance representative to better understand how your policy works and what it covers.

Please bring your child's insurance identification card with you to UCSF Benioff Children's Hospital. Your insurance may require prior authorization for your child to be seen by a UCSF doctor. If so, please have your child's primary care doctor or insurance company fax your authorization to the UCSF doctor's office and bring a copy to the appointment to ensure you aren't billed for medical services covered by your insurance. You may be called for insurance or authorization information before your appointment.

Your insurance may require an office co-payment. If so, you will be asked to make your co-payment in full at your visit. If your visit is not covered by a health plan or insurance, you will be asked to pay for your visit on arrival. For your convenience, we accept cash, checks and credit cards.

UCSF Benioff Children's Hospital contracts with many major health insurance companies and accepts several Medicare and Medi-Cal plans. A list of health insurance companies and Medicare and Medi-Cal programs that provide coverage for our services is available below.

Our hospitals and doctors do not contract with or participate in health insurance discount card programs. We do, however, accept payments made through health savings account (HSA) programs.

UCSF also can make financial arrangements for your coverage with health insurance companies that don't have contracts with UCSF, if the companies are willing to do so. If your health insurance company is not listed below, please ask your insurance company or your UCSF doctor to contact our Health Plan Strategy and Contracting office at (415) 353-9020 to discuss possible arrangements.

NOTE:

  • The state Healthy Families plan was phased out in 2013. All eligible children were enrolled into Medi-Cal or Medi-Cal Managed Care.
  • As of Jan. 1, 2015, UCSF is not contracted with Health Net's Covered California EPO product.

HEALTH PLANTYPE OF PLAN
 
Aetna (Except Aexcel Network)All Plans
Aetna CitizenHMO
Aetna Elect Choice (EC)EPO
Aetna Managed Choice (MC)POS
Aetna Open ChoicePPO
Aetna QPOSPOS
Aetna Select Choice Referral Only Medi-Cal HMO
Alameda Alliance for HealthMedi-Cal and Medicare Special Needs
Medi-Cal HMO
Anthem Blue Cross CaliforniaCareHMO
Anthem Blue Cross CaliforniaCare Medi-Cal HMO
Anthem Medi-Cal HMO
Anthem Blue Cross -- Covered California Exchange, IFP & SHOP (Small Business) EPO (Tier 1) & PPO
Anthem Blue Cross Plus POS
Anthem Blue Cross Prudent Buyer PPO
Anthem Blue Cross / Blue Shield Rare & Complex
    Cancer Network
ASMED Health PartnershipPPO
 
Beech Street (via Multiplan)PPO
Blue Cross (See Anthem Blue Cross)
Blue Shield 65 + Medicare HMO
Blue Shield Access + HMO
Blue Shield Covered California, IFP and SHOP (Small Business) - PPO PPO
Blue Shield HMO Plus POS
Blue Shield Preferred PPO
Blue Shield Preferred Plus PPO
Blue Shield SELECT PPO
Blue Shield TRIO - HMO and Covered CA HMO
 
Canopy Health/Health Net Blue & Gold HMO
Central California Alliance for Health Referral Only Medi-Cal HMO
Chinese Community Health Plan Referral Only HMO
Choice Care/Humana PPO
CIGNA HMO HMO
CIGNA POS POS
CIGNA PPO PPO
CorVel Corp. PPO
Coventry (First Health) EPO, PPO
 
Definity Health PPO
 
First Health (Coventry) EPO, PPO
Foundation for Medical Care (multiple counties) PPO
 
Great West Healthcare (Cigna) All Plans
Great West Healthcare (Cigna) HMO
 
Health Net Blue & GoldHMO
Health Net Covered CA IFP PPO (off-exchange) ONLY
Health Net Covered CA Small Business (SHOP) PPO ONLY
Health Net ELECT POS
Health Net HMO HMO
Health Net PPOPPO
Health Net Seniority Plus Medicare HMO
Health Plan of San Joaquin Referral Only Medi-Cal HMO
Health Plan of San Mateo Medi-Cal Managed Care (PEDIATRICS ONLY) HMO
Health Smart/ Interplan Corp. PPO
Humana/Choice Care PPO
 
Interlink Transplant Network
Interplan Corp./Health Smart PPO
 
Kaiser Permanente Added Choice/PHCS Network POS
Kaiser Permanente ASOPPO
Kaiser Permanente Dual Choice/PHCS Network PPO
Kaiser Permanente HMO Referral Only HMO
 
Medi-CalCalifornia Program
MedicareFederal Program
Merced Foundation for Medical Care PPO
Multiplan (includes Beech Street and PHCS) PPO
 
Networks by Design PPO PPO
 
On Lok Senior Health Services Referral Only HMO
Oscar Health Covered CA EPO IFP and Small Business EPO
 
Pacific Health Alliance PPO
PacifiCare Choice POS
PacifiCare HMO HMO
PacifiCare PPO PPO
PacifiCare Secure Horizons HMO (Senior Plan) Medicare HMO
Partnership Health Plan, Medi-Cal, Medicare
    Referral Only
Medi-Cal HMO, Medicare Special Needs
PPO NEXT PPO
Private Health Care Systems (PHCS) (via Multiplan)PPO
 
San Francisco Foundation for Medical CarePPO / EPO
San Francisco Health Plan Healthy Families
    Referral Only
HMO
San Francisco Health Plan, Referral Only From SF     Medical Groups Medi-Cal HMO
San Francisco Health Plan UCSF Primary Care Medi-Cal HMO
San Francisco Health Plan/SF Cares for Kids Medi-Cal HMO
San Joaquin Foundation for Health Care PPO / EPO
Stanislaus Foundation for Medical Care PPO / EPO
 
TriCare Extra / TriWest (CHAMPUS) PPO
TriCare Prime / TriWest (CHAMPUS) HMO / POS
 
UCSF Student Health Services (administered by Anthem Blue Cross)
United HealthCare/OPTUM CHOICE Plus POS
United HealthCare/OPTUM CHOICE PPO
United HealthCare/OPTUM EPO
United HealthCare/OPTUM Options PPO
United HealthCare/OPTUM Select Plus POS
United HealthCare/OPTUM/PacifiCare Secure Horizons     (Senior Plan) Medicare HMO
United Resource Network — Transplant and     Oncology Networks
UC Care (administered by Anthem Blue Cross) PPO
USAccess/Aetna POS
 

Last updated February 28, 2017

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