Employer Sponsored Group Plan

Stanford Children’s Health is in-network with most major commercial health plans that employers offer their employees. Some employers choose to offer “narrow” networks that have very limited options with specific providers in their network. You should always check with your employer’s benefit department to determine if there are any unique or narrow networks within your plan.

Stanford Children’s Health is contracted and in-network with the following employer sponsored group plans. Please review your plan below for more information.

Aetna HealthSmart
Anthem Blue Cross  Humana
Blue Shield Kaiser
Blue Cross/Blue Shield (out of state) Multiplan
Blue Cross/Blue Shield (Federal Employee) Private Health Care Systems
Beech Street Stanford Health Care Alliance
Coastal Healthcare Administrators Sutter Health Plus HMO
Cardinal Care Sutter Select
Cigna  United Health Care
Coventry Valley Health Plan
First Health All Other Commercial Group Employer Plans
Health Net  

Aetna

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Anthem Blue Cross

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.  

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Blue Shield

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.  

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Blue Cross/Blue Shield (out of state)

Stanford Children’s Health and its physicians are in-network with out of state Blue Cross/Blue Shield plans, as long as the plan utilizes the nationwide network of providers. This is known as the Blue Card network. Most employer sponsored plans will include this network, especially if they have employees located in multiple states. Please contact your health plan or your employer to inquire about access to this network.

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Blue Cross/Blue Shield (Federal Employee)

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians. 

If you have a PPO/EPO/POS plan:Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Beech Street

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.     

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Coastal Healthcare Administrators

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

Cardinal Care

This is a health plan offered by Stanford University to Stanford University students. It is an EPO plan, and Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Cigna

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services. In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health physicians.

If you have a PPO/EPO/POS OAP plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Coventry

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.        

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

First Health

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Health Net

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

HealthSmart

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.       

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Humana

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org  

 

Kaiser

Kaiser HMO members must obtain a referral from their Kaiser primary care or specialist physician and an authorization from their health plan for any services to be covered and considered in-network at Stanford Children’s Health. You would not be able to select a Stanford Children’s Health physician as your primary care physician/general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Multiplan

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.  

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Private Health Care Systems

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Stanford Health Care Alliance

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Sutter Health Plus HMO

Stanford Children’s Health and Lucile Packard Children’s Hospital Stanford are in-network for hospital and specialist physician services. Sutter Health HMO members must get a referral from their primary care physician and an authorization from their health plan for any services to be covered and considered in-network at Stanford Children’s Health. You would not be able to select a Stanford Children’s Health physician as your primary care physician/general pediatrician.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Sutter Select

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network providers with Sutter Select. Sutter Select’s provider network is comprised of Sutter Health hospitals and physicians, and they extend their network by contracting with non-Sutter providers as needed. However, Sutter expects that services will be provided by its own Sutter provider network and will only grant authorizations as an exception.

If you have the PPO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services. Prior authorization is encouraged so patients receive Tier 1 benefit levels. If authorization is not granted by Sutter Select, the services may be considered out of network, or at a lower tier benefit level.

If you have the EPO or EPO Plus plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services. Prior authorization is required for all services in order for the services to be covered.  Sutter Select will only authorize the services if there aren’t any Sutter Health providers available in their own network that can provide the service.

Stanford Children’s Health physicians that practice at California Pacific Medical Center and certain primary care physicians in the East Bay are in-network with all Sutter Select products and do not require prior authorization for office visits/consultations. Surgeries/advanced procedures still require prior authorization. For a roster of physician names at CPMC and pediatricians in the East Bay, contact Sutter Select by calling the phone number on your insurance ID card.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

United Health Care

If you have a HMO plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital, specialist physician services, and primary care physician services. Our primary care physicians (PCPs) are affiliated with various medical groups within your health plan network. Please check your health plan website or contact your health plan to select a medical group in order to choose your PCP.

In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health specialist physicians.        

If you have a PPO/EPO/POS plan: Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for all hospital and physician services. This includes specialist and primary care/general pediatrician physician services.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

Valley Health Plan

Stanford Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital and specialist physician services only. You would not be able to select a Stanford Children’s Health physician as your primary care physician/general pediatrician. In order to be seen at Stanford Children’s Health, your primary care physician must refer you and your medical group or health plan must /authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Children’s Health physicians.

What are specialist services? Specialist services are services by physicians specializing in advanced areas such as Cardiology, Neurology, Surgery, Oncology, etc. This is different than your general pediatrician.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org

 

All Other Employer Sponsored Group Plans

If your health plan is not included on the list of in-network plans, that means that Stanford Children’s Health most likely does not have a contract with your plan. You can email the Managed Care Department for confirmation.

Have further questions? Email the Managed Care Department at managedcare@stanfordhealthcare.org