Alyssa Lane
Providence Medical Group is contracted with most major insurance carriers and accepts many HMO, PPO, and Medicare health insurance plans. Providence also participates in California's Medicaid program, known as Medi-Cal, which offers medical services to children and adults with limited resources. To verify coverage, individuals are advised to contact their insurance carrier directly.
| Characteristics | Values |
|---|---|
| Southern California | Mission Hospital, St. Joseph Hospital, and St. Jude Medical Center |
| Medical groups in Southern California | Mission, St. Joseph, St. Jude Heritage Medical Groups, Mission, St. Joseph and St. Jude Affiliated Physicians, St. Mary High Desert Medical Group, Providence Affiliated Physicians |
| Northern California | St. Joseph Hospital Eureka, Redwood Memorial Hospital, Queen of the Valley Medical Center, Santa Rosa Memorial Hospital, Petaluma Valley Hospital |
| Medical groups in Northern California | Providence Medical Group, Humboldt, Providence Medical Group, Napa, Providence Medical Group, Sonoma, Providence Medical Network |
| Accepted insurance types | HMO, PPO, Medicare, Medi-Cal |
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What You'll Learn
Providence works with major insurance carriers
In Southern California, Providence is contracted with most major insurance carriers. In Los Angeles County, Providence is known as Providence Holy Cross Medical Center, Providence Little Company of Mary Medical Center, Providence Saint John's Health Center, Providence Saint Joseph Medical Center, and Providence Cedars-Sinai Tarzana Medical Center. Providence's multi-specialty medical groups in Los Angeles County include Axminster Medical Group, Facey Medical Group, Providence Medical Associates, Providence Medical Institute, Saint John's Physician Partners, and Providence Affiliated Physicians.
In Orange County, Providence is known as Mission Hospital, St. Joseph Hospital, and St. Jude Medical Center. Medical groups include Mission, St. Joseph, and St. Jude Heritage Medical Groups, as well as Mission, St. Joseph, and St. Jude Affiliated Physicians.
In Northern California, Providence is also contracted with most major insurance carriers. In Humboldt County, Providence is known as St. Joseph Hospital Eureka and Redwood Memorial Hospital, with the medical group being Providence Medical Group, Humboldt. In Napa, Providence is known as Queen of the Valley Medical Center, and the medical group is Providence Medical Group, Napa. In Sonoma County, Providence is known as Santa Rosa Memorial Hospital and Petaluma Valley Hospital, with medical groups including Providence Medical Group, Sonoma, and Providence Medical Network.
Additionally, Providence offers education about Medicare health plan options through its Providence Medical Institute. This includes hosting educational seminars, in conjunction with a licensed independent insurance broker, to explain all options available to those who will become eligible for Medicare.
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HMO, PPO, and Medicare plans accepted
In Southern California, Providence is contracted with most major insurance carriers and accepts many HMO, PPO, and Medicare health insurance plans. The medical groups include Mission, St. Joseph, and St. Jude Heritage Medical Groups, and Mission, St. Joseph, and St. Jude Affiliated Physicians. In Orange County (OC), Providence is known as Mission Hospital, St. Joseph Hospital, and St. Jude Medical Center.
In Northern California, Providence is also contracted with most major insurance carriers and accepts many HMO, PPO, and Medicare health insurance plans. The medical groups include Providence Medical Group, Humboldt, in Humboldt County; Queen of the Valley Medical Center and Providence Medical Group, Napa, in Napa; and Santa Rosa Memorial Hospital and Petaluma Valley Hospital, with medical groups Providence Medical Group, Sonoma, and Providence Medical Network, in Sonoma County.
The Medicaid program for low-income individuals and families is known as Medi-Cal in California, and Providence participates in this state program, which offers medical services for children and adults with limited resources. For seniors qualifying for Medicare, you may opt to purchase a Medicare Advantage or Medicare Supplement plan. Providence Medical Institute offers education about Medicare health plan options, including Medicare Advantage plans with $0 monthly premiums.
Please note that you should call your insurance carrier to verify coverage.
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Medicaid/Medi-Cal for low-income families
In Southern California, Providence is contracted with most major insurance carriers and accepts many HMO, PPO, and Medicare health insurance plans.
The Medicaid program for low-income individuals and families is known as Medi-Cal in California. Providence participates in California's state program, which offers medical services for children and adults with limited resources. Eligibility requirements for Medi-Cal are currently expanding. To check eligibility or for a list of participating physicians, visit www.dhcs.ca.gov or call 800-541-5555.
For seniors qualifying for Medicare, you may opt to purchase a Medicare Advantage or Medicare Supplement plan. If you currently purchase a private health insurance policy, you have two options: purchase a plan through Covered California (Exchange) or directly from an insurance carrier.
Please note that insurance acceptance may vary depending on the specific Providence medical center or group. It is recommended to call your insurance carrier to verify coverage.
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Medicare Advantage or Supplement plans for seniors
Providence Medical Group offers Medicare Advantage (Part C) and Supplement plans for seniors. These plans are available in select counties across Oregon, Washington, and Southern California.
In Southern California, Providence contracts with major insurance carriers and participates in the state's Medicaid program, known as Medi-Cal. Providence also offers Medicare Advantage plans in Orange County, featuring access to award-winning hospitals, medical offices, urgent care clinics, and senior specialty care.
In Oregon, Providence Health Assurance is an HMO, HMO-POS, and HMO SNP with Medicare and Oregon Health Plan contracts. They offer a Dual Special Needs Plan (D-SNP) that coordinates Medicaid and Medicare coverage, providing extra benefits and savings. Additionally, some plans include prescription drug benefits and optional dental supplements.
In Washington, Providence provides Medicare Advantage plans in three counties in southwest Washington.
For seniors qualifying for Medicare, there is the option to purchase a Medicare Advantage plan or a Medicare Supplement plan. These plans offer different benefits, and it is essential to review the available options to choose the one that best suits your needs.
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Private insurance: Covered California
In Southern California, Providence is contracted with most major insurance carriers and accepts many HMO, PPO, and Medicare health insurance plans. If you have private health insurance, one option is to purchase a plan through Covered California, the state-run health insurance exchange.
Covered California is the government agency offering subsidized Obamacare plans for the state. It was created to assist citizens and legal residents in applying for marketplace coverage to comply with the Affordable Care Act. The agency offers health, dental, and vision care plans. Children under 19 get free vision care, and there are health and dental options for small businesses with 1 to 100 employees.
Individuals and families with a qualifying life event can enroll outside of the open enrollment period. The main coverage requirement is that the insurance must cover the 10 minimum essential benefits, such as preventive services, prescription drug coverage, and maternity and newborn care. For people with a household income below 400% of the Federal Poverty Level, Covered California may qualify them to receive financial assistance, which reduces their premium. If income is between 138% and 250% of the Federal Poverty Level, individuals may also qualify for "Cost Sharing Reductions" that lower the cost of medical services.
To be eligible for financial assistance, you must fall within Covered California income limits and not have access to affordable, full-coverage healthcare through an employer, Medicare, etc. Enrollments need to be submitted through the State Marketplace, a Certified Insurance Agent, or a Certified Enrollment Counselor.
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Frequently asked questions
Providence Medical Group is contracted with most major insurance carriers in Northern California. They accept many HMO, PPO, and Medicare health insurance plans.
In Southern California, Providence Medical Group is known by different names in different counties. In Humboldt County, they are known as St. Joseph Hospital Eureka and Redwood Memorial Hospital, and in Sonoma County, they are known as Santa Rosa Memorial Hospital and Petaluma Valley Hospital. Providence Medical Group accepts many HMO, PPO, and Medicare health insurance plans in Southern California as well.
Providence Medical Group participates in California's Medicaid program, known as Medi-Cal, which offers medical services for children and adults with limited resources.
