Health Insurance Coverage Information

Important Dates You Need to Know About Open Enrollment
  • Medicare open enrollment is Oct. 15 to Dec. 7.
  • Covered California open enrollment is Nov. 1, 2015, to Jan. 31, 2016.
  • Employer open enrollment dates vary – check with your employer for the exact dates.
  • California Medi-Cal open enrollment is year-round.
  • California MediConnect is a program for Medicare and California Medi-Cal dual eligibles – enroll during Medicare open enrollment (Oct. 15 to Dec. 7) to choose the plan that best meets your needs.

Make sure nothing’s missing from your health care

You’ve come to rely on Providence as your partner in health. From specialty care to hospital stays, we’ve been there. So it makes sense to keep your relationship going with Providence. Great care doesn’t come from just anyone; if you want your favorite neurologist or your trusted cardiologist or the ease of visiting a hospital that’s close to home, make sure Providence is part of your plan.

The choices you make during open enrollment can affect your costs, the services you receive, and the doctors and hospitals you’re able to use. Providence can help simplify your decision-making – whether you’re enrolled in a Medicare plan, get insurance through your employer or need to buy individual health insurance coverage.

At Providence, we can help you understand your choices. Our strong network of six hospitals, more than 56 clinics and more than 3,600 doctors covering the South Bay, Westside and the Santa Clarita and San Fernando valleys is among the largest in the Greater Los Angeles Area. And Providence has been recognized for exceptional care time and again in national quality ratings and by accreditation organizations. We’re contracted with most major health plans, including Medicare and Medicare Advantage, and with many medical groups.

For more information, choose the option below that meets your needs:

Should I shop for a new or different health plan?

Maybe. You may need to choose a new plan if you fall into one of these categories:

  • You don’t currently have health insurance. You may be eligible for premium subsidies through Covered California.
  • You have an individual plan, but your insurance company is ending that policy. Covered California is the source for affordable individual plans.
  • You’re insured under a plan provided by your spouse’s employer, but spouses won’t be covered in the future. Covered California has many plans to choose from.
  • Your current plan doesn’t let you see Providence doctors or go to Providence facilities. To access the Providence network of hospitals, clinics and doctors, you need to choose a plan that is accepted by Providence. That way, you’ll receive high-quality care at in-network rates. In-network means less out-of-pocket costs for you. To see the accepted plans, click here or call 866-909-DOCS (3627).

What are my Medicare options?

What are my Medicare options?

You become eligible for Medicare in a seven-month window: three months before the month you turn 65 until three months after the month you turn 65. If you didn’t enroll when you were first eligible, you can do so during the Annual Election Period, also called open enrollment. This period runs from Oct. 15 to Dec. 7 each year. If you are already enrolled in Medicare, you can switch health plans during this period.

You also may be able to enroll in Medicare during Special Election Periods. You may need to do this if you move to a new service area, if you have both Medicare and Medicaid, or if you have certain special needs. Visit for more information and assistance.

Contact Providence to learn about the best Medicare choice for you

A number of Medicare plans include Providence. Which is right for you will depend on your life situation. Providence offers Medicare informational events to help you understand your options. For more information about an event near you, call 866-909-DOCS (3627) or click here.

What if I have BOTH Medicare and Medi-Cal?

If you qualify for both Medicare and Medi-Cal, you are considered “dual-eligible.” California has a special program for dual-eligibles called Cal MediConnect. This program is designed to provide a coordinated and seamless system to improve health care and help members remain at home longer. Cal MediConnect coordinates all Medicare and Medi-Cal benefits under one health plan with benefits such as medical care, prescription drugs, long-term services and support, connections to social services, and mental and behavioral health care. You can call Providence for more information at 866-909-DOCS (3627) or visit CalDuals for additional information. Providence accepts the following Cal MediConnect plans:

  • Health Net Cal MediConnect
  • LA Care Cal MediConnect

Do I qualify for Medi-Cal?

Medi-Cal is California’s free or low-cost health coverage for children and adults with limited income and resources. To apply, go to Covered California, where a single application will let you know if you qualify for Medi-Cal coverage. You also can apply in person at your local county human services agency or over the phone by calling 800-300-1506. If you qualify, Medi-Cal will mail a packet of available health plans to choose from. Providence accepts the following Medi-Cal plans:

  • Americas Health Plan
  • Anthem Blue Cross Medi-Cal, Healthy Families, Access for Infants and Mothers (AIM)
  • Care 1st Medi-Cal
  • Gold Coast Health Plan
  • Health Net Medi-Cal
  • LA Care Medi-Cal
  • Molina Medi-Cal and Health Families

What about buying insurance on my own?

The law requires everyone to have health insurance or pay a tax penalty. There are two ways to purchase an individual insurance policy: directly through an insurance company, or through the state’s health benefit exchange, Covered California. Covered California has been affordable for millions of Californians and it offers a range of plans. You can apply for Covered California online here, in person, or on the phone at 800-300-1056. If you purchase your insurance through Covered California, make sure the plan you choose includes Providence hospitals, clinics and doctors. Providence accepts these plans from Covered California:

  • Anthem Blue Cross HMO Covered California
  • Blue Shield Covered California Shop
  • Blue Shield HMO Covered California
  • Blue Shield PPO Covered California
  • Health Net Covered California – all products
  • LA Care Covered California

Choosing insurance through your employer

If you receive health insurance for yourself and dependents through your employer, contact your benefits department to find out when open enrollment starts. Often, enrollment is not automatic and you may be eligible to change health plans. Employers typically contract with one or more health plans for their employees, and individual contribution rates can vary by plan. Plan offerings can change from year to year, so look for the plan with the benefits, physicians and facilities that best fit the needs of your family. The Patient Protection and Affordable Care Act requires all health plans to provide some types of coverage. They include coverage for preventive care and the ability to keep children on an insurance policy until they are 26 years old. Check with your employer to see what plans are offered through work.

Providence contracts with many health insurance plans. To use the Providence network of hospitals, clinics and doctors, you must choose a health plan that is accepted by Providence. To find out if your doctor is contracted with a health insurance plan that Providence accepts, call 866-909-DOCS (3627) or visit the Providence Medical Institute.

Employer Plans Contracted With Providence

  • Anthem Blue Cross Medicare Advantage HMO
  • Blue Shield 65+
  • Brand New Day
  • Caremore Senior
  • Central Healthplan of CA – HMO and Senior
  • Health Net Medicare Advantage
  • Humana Medicare Advantage
  • SCAN Healthplan-Senior
  • United Health Care Secure Horizons
  • See a full list of health plans here

So, What’s Next?

If you need more information to make an informed choice about your health care, please call Providence Customer Service at 866-909-DOCS (3627). Specialists are available to help 7 a.m. to 8 p.m., Monday through Friday, and 9 a.m. to 2 p.m. on Saturday.

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