Options for Purchasing Individual Coverage

I Buy Health Insurance On My Own

If you purchase a private (or "commercial") policy for yourself or your family, rather than receiving it from your employer or a public program, you have two options:

  • Purchase a plan through the Covered California health benefit exchange
  • Purchase a plan sold outside of the health exchange where there are a broader set of options but plans are not eligible for income-related subsidies.

Either way, please choose your plan carefully. The plans that provide full coverage for care from Cedars-Sinai Medical Center and many of our physicians have changed from last year. Most independent insurance agents and health insurance companies will be able to review your options both on and off of the exchange and help you select a plan that is right for you. Certified Enrollment Counselors (or "navigators") and the public employees who staff the call center for Covered California, however, can assist only assist you in selecting plans on the exchange.

Open enrollment for individual and family insurance policies runs from Nov. 15, 2014, through Feb. 15, 2015. If you are currently enrolled in a product, you will be automatically reenrolled in that product on Dec. 15, although you will be able to switch plans until Feb. 15. Click below to review your options for coverage that include Cedars-Sinai. (We will continue to update this information as we receive additional details from the insurance companies.)
 

Financial Assistance:

We offer a variety of financial assistance programs that can help our patients with out-of-pocket costs. These programs are available to a wide range of incomes.

 

Coverage through the health benefit exchange:

Covered California health benefit exchange

If you choose to purchase your health insurance through the Covered California exchange and want the option of receiving full coverage for care provided by Cedars-Sinai Medical Center and many of our physicians, you will need to choose:

  • Anthem Blue Cross EPO plans (all metal levels – e.g., Platinum, Gold, Silver, Bronze)

Health Net UPDATE: Please note that effective Jan.1, 2015, Health Net will no longer offer a PPO plan through Covered California. They will be offering a new narrow-network plan called PureCare HSP, which stands for Healthcare Service Plan. At this time, it is unclear whether Cedars-Sinai will be included as a participating provider in the PureCare HSP. Continue to check our website for updates. If you currently have coverage through Covered California with a Health Net PPO plan, you may need to change plans if you want to continue to have access to Cedars-Sinai. For more information, call 877-527-8409 or visit Health Net's website.

None of the other plans in the Covered California health benefit exchange will allow you to receive full coverage for care provided by Cedars-Sinai Medical Center and our physicians. Please note that many health insurance companies will be offering plans both within and outside of the exchange, so be sure to compare carefully.

If you qualify for and choose to accept a subsidy from the federal government to help with your premium, you will be limited to the policies sold by Covered California. This is a more limited set of plans that generally have fewer hospitals and doctors in their networks.

Please note, emergency care provided at any emergency room – including Cedars-Sinai’s Emergency Department – is covered through all insurance plans, whether they are part of the exchange or not.

To learn more, visit www.coveredca.com or call 888-975-1142.

*Information updated Nov. 11, 2014


 

Coverage purchased directly from an insurance company:

Anthem Blue Cross (Covers Cedars-Sinai)

All metal levels (e.g., Platinum, Gold, Silver, Bronze) of Anthem Blue Cross EPO plans provide full coverage for care from Cedars-Sinai Medical Center and many of our physicians.

Cedars-Sinai Medical Center is offered as an in-network hospital in PPO plans and as a Tier 1 facility in Exclusive Provider Organization (EPO) plans.

If you have a grandfathered plan with Anthem Blue Cross that offers their full network of providers, you will be able to keep coverage under that grandfathered plan in 2015 as long as you continue to pay premiums under the plan.

Please confirm plan participation with your physician or Anthem.

For more information on Anthem’s individual and family plans, call 866-249-4844 or visit Anthem’s website.

*Information updated Nov. 11, 2014

Assurant Health (Covers Cedars-Sinai)

Assurant Health offers a full range of PPO network plans - using the Aetna PPO physician and hospital network – that include Cedars-Sinai Medical Center and many of our physicians.

  • Click here for plan details.
  • Click here to determine if a provider is covered.
  • Call 800-358-9931 for assistance in enrolling in an Assurant Health plan.

*Information updated Nov. 11, 2014

Health Net

We are currently in active discussions with Health Net. At this time, it is unclear whether Cedars-Sinai will be included as a participating provider in Health Net's PPO network. Please continue to check our website for the latest updates.

*Information updated Nov. 11, 2014

Aetna

Aetna will not offer plans to individuals in California.

*Information updated Nov. 11, 2014

Cigna

Cigna has changed its provider network for individual coverage.

  • All current Cigna individual and family plan members who are enrolled in one of Cigna's full-network plans (called OAP Network Plans) will need to seek new coverage effective Jan.1, 2015.
  • Cigna will no longer be offering full-network plans. All new Cigna individual and family plans are Cigna's Local Plus Network that exclude the majority of Cedars-Sinai physicians.

*Information updated Nov. 11, 2014

Blue Shield of California (Grandfathered Coverage)

Blue Shield’s new individual and family plans for 2015 do not include Cedars-Sinai Medical Center and our physicians in its new network of providers.

If you have a grandfathered plan with Blue Shield that offers their full network of providers, you will be able to keep coverage under that grandfathered plan in 2015 as long as you continue to pay premiums under the plan.

Please confirm plan participation with your physician or Blue Shield. For more information, visit Blue Shield's website.

*Information updated Nov. 11, 2014

United Healthcare

As of Jan. 1, 2014, United Healthcare is not offering plans to individuals in California.

*Information updated Nov. 11, 2014


For more guidance, click the option that best describes your situation.

I Get My Health Insurance Through My Employer

I Buy Health Insurance On My Own

I Have Medicare

I Have Medi-Cal

I Have BOTH Medicare and Medi-Cal

I Don’t Have Health Insurance

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