Better health is just around the corner.

The last thing you want to worry about right now is where to go when you need medical care. You can worry less knowing safe and dependable care is just around the corner.

During this open enrollment season, take one less thing off your list and make sure your plan includes a doctor with Palomar Health.

If you have one of the health plans listed below, our hospitals and doctors are available to you! All you need to do choose your doctor.

FIND A DOCTOR
 

Palomar Health Plan Partners

Aetna (does not include Meidcare Advantage Plans)
Anthem
Blue Shield
Health Net
Sharp Health Plan
UnitedHealth
 
Palomar Health understands North County like no other health system in San Diego and has been committed to providing the best care to our neighbors for more than 70 years. We are proud to be neighbors serving neighbors.

Here’s a few more reasons why you should make Palomar Health your choice for care.

Outstanding Local Hospitals

When it comes to quality health care, having access to award-winning expertise is important. As the most comprehensive health care system in North County, there’s a convenient location near you!

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Friendly, High-Quality Care

Our medical groups are joining forces to provide you with more access to top doctors who focus on your personal health story and put your needs first to deliver personalized care to every patient, every day.

FIND A DOCTOR
 

Mayo Clinic Expertise

Palomar Health is proud to be the ONLY health system in San Diego that is part of the prestigious Mayo Clinic Care Network – providing our doctors and patients with access to Mayo Clinic expertise, right here at home.

MAYO CLINIC ACCESS
 

Award-Winning Care

Palomar Health has been nationally recognized for providing top quality care to our patients for years. But you don’t have to take our word for it, US News, Newsweek, Healthgrades and others can confirm.

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Classes & Events

 

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Insurance coverage can be confusing, so here’s a little more information that may help.
 

Medicare Advantage

What is traditional Medicare?

Traditional Medicare is administered by the government and includes a few separate types of coverage that must be pieced together to provide complete healthcare coverage. Generally speaking:
    Medicare Part A covers inpatient services like hospital stays
    Medicare Part B covers outpatient services including medical procedures and equipment
    Medicare Part D covers prescription drugs
Supplemental coverage, which is optional, covers additional items like co-pays

What is Medicare Advantage?

Medicare Advantage plans are administered by private insurers on behalf of the government. Medicare Advantage:
    Is also known as Medicare Part C
    Combines all the services offered through traditional Parts A and B
Often includes Part D prescription drug coverage

Why are more people choosing Medicare Advantage?

More and more consumers are choosing Medicare Advantage over traditional Medicare because these plans:
    Are more convenient, combining Medicare Parts A, B, and D into one package with a single insurance card
    Are more affordable than the combined cost of traditional Medicare and supplemental coverage
Usually offer additional coverage not provided through traditional Medicare like routine dental and hearing care
 

Insurance Through Your Employer

Choose the right type of health plan

Your employer may offer different types of health plans, whose different rules may affect the way that you receive care.
Some common types of plans your employer could offer include:

PPO: Preferred Provider Organization A type of health plan in which you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.

HMO: Health Management Organization A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.

POS: Point of Service Plan A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.

EPO: Exclusive Provider Organization A managed care plan in which services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).

HDHP: High-Deductible Health Plan A health plan that features a limited amount of covered services.

Source: Healthcare.gov

How much will I pay for healthcare this year?

The amount you pay will be a combination of the following items:

Your monthly premium, which may or may not pay for your Medicare Part B coverage

The care you receive and any co-pays for doctors, facilities, tests, or procedures

Very importantly, the cost of the care you receive can go up if you utilize providers that are out-of-network for the plan you select or do not follow all of the plan’s rules

Your deductible, or how much you will pay before insurance covers any additional amount

The co-insurance rate, or the percentage you will pay for any medical care you receive after your deductible but before you reach your yearly out-of-pocket maximum or limit

Your out-of-pocket maximum or limit, which is the most you have to pay for medical care in a plan year—after you spend your out-of-pocket maximum on deductibles, co-payments, and co-insurance, your health plan pays 100% of the rest of covered benefits
 

Covered California

What is Covered California?

Covered California is where Californians can purchase health insurance under the Affordable Care Act. It’s the only place where you can get assistance for your health insurance premiums from the federal government. Depending on your income and the individuals in your household, that means you may qualify for a discount on a health plan through Covered California.

What is Medi-Cal?

Medi-Cal is a statewide program that offers free or low-cost health coverage for children and adults with limited income and resources. This coverage is offered as a public assistance program by the state of California.

What is the difference?

Medi-Cal offers low-cost or free health coverage to eligible California residents with limited income. Covered California is the state’s health insurance marketplace where Californians can shop for health plans and access financial assistance if they qualify for it.