Individual and Covered California Plans

Not all of these health plans may not be available in your specific county. For further information, please contact Covered California or a licensed insurance broker to determine if any of these plans are available for purchase in your region.

Please view your plan for more information.

2018 Covered California FAQs

2018 Plans

Blue Shield Trio HMO Kaiser HMO
Health Net PPO Valley Health Plan HMO
                                                                                           All Other Individual/Covered California Employer Plans
   

Blue Shield Trio HMO

Lucile Packard Children's Hospital Stanford is in-network for hospital services. Your assigned medical group (John Muir IPA, Hill Physicians, Sequoia Physicians, SCCIPA, or PMG- Santa Cruz) must refer and authorize all services provided by Stanford Children’s Health specialists.

Certain Stanford Children’s Health primary care physicians are in-network via their affiliations with John Muir IPA, SCCIPA, Hill Physicians, and Sequoia.

View the list of Stanford Children’s Health Pediatricians that are in-network with each of those medical groups.

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 PPO

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.*

*This plan is not available on the Covered California exchange. You must purchase this plan with the assistance of a licensed insurance broker, or through HealthNet directly.

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

 

Kaiser HMO

Kaiser HMO members must get 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.

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 HMO

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 Individual/Covered California Plans

If your health plan is not included on this list of in-network plans that means that Stanford Children’s Health 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

Learn more

For further information, please contact Covered California or a licensed insurance broker to determine if any of these plans are available for purchase in your region. Read the Covered California FAQs.

 

2017 Covered California FAQs

2017 Plans

Cigna Kaiser HMO
Health Net Valley Health Plan
                                                                                           All Other Individual/Covered California Employer Plans
 

Cigna

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

*These plans are not available on the Covered California exchange. You would need to purchase one of these plans with the assistance of a licensed insurance broker, or through Cigna directly.

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/HSP 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. However, you can only select a primary care physician that is located in Santa Clara County.

If you have a 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.*

*This plan is not available on the Covered California exchange. You must purchase this plan with the assistance of a licensed insurance broker, or through HealthNet directly.

If you have an EPO 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 get 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.

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 Individual/Covered California Plans

If your health plan is not included on the list of in-network plans, that means that Stanford Children’s Health 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