Employer Sponsored Group Plans
Stanford Medicine Children’s Health accepts 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 Medicine Children’s Health accepts the following employer sponsored group plans. Please review your plan below for more information.
Aetna
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Anthem Blue Cross
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Anthem offers plans with a narrow network and in such cases, limits the providers that are allowed to participate in the product/network. The High Performance EPO product is an example of an EPO plan that has a narrow network. Lucile Packard Children’s Hospital is considered in-network but Stanford Medicine Children’s Health physicians are considered out-of-network. Refer to your employer or Anthem to determine if your plan has a narrow network of providers.
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.
Blue Shield
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Blue Cross/Blue Shield (out of state)
Stanford Medicine 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 Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Blue Cross/Blue Shield (Federal Employee)
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan:Stanford Medicine 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.
Beech Street
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Coastal Healthcare Administrators
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Cardinal Care
This is a health plan offered by Stanford University to Stanford University students. It is an EPO plan, and Stanford Medicine 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.
Cigna
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health physicians.
If you have a PPO/EPO/POS OAP plan: Stanford Medicine 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.
Coventry
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
First Health
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Health Net
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
HealthSmart
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
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 Medicine Children’s Health. Our Primary Care Physicians do not participate in the Kaiser HMO network.
Multiplan
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Private Health Care Systems
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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.
Stanford Health Care Alliance
Stanford Medicine 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.
Sutter Health Plus HMO
Stanford Medicine 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 Medicine Children’s Health. Certain Stanford Medicine Children’s Health pediatricians through affiliation with select medical groups may be selected as Primary Care Physicians. Please check your health plan website for Primary Care Physician availability.
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.
Sutter Select EPO Plus and PPO
Stanford Medicine Children’s Health (specialists and Primary Care Physicians) and Lucile Packard Children's Hospital Stanford are in-network providers with Sutter Select. Standard prior authorizations apply as required by Sutter Select.
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.
United Health Care
If you have a HMO plan: Stanford Medicine 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 Medicine 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 Medicine Children’s Health specialist physicians.
If you have a PPO/EPO/POS plan: Stanford Medicine 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. United Health Care offers plans with a narrow network and in such cases, limits the providers that are allowed to participate in the product/network. The CORE product is an example of a PPO plan that has a narrow network. Lucile Packard Children’s Hospital is considered in-network but Stanford Medicine Children’s Health physicians are considered out-of-network. Refer to your employer or United Health Care to determine if your plan has a narrow network of providers.
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.
Valley Health Plan HMO
Stanford Medicine Children’s Health and Lucile Packard Children's Hospital Stanford are in-network for hospital and specialist physician services only. Certain Stanford Medicine Children’s Health pediatricians through affiliation with Santa Clara County IPA (SCCIPA) may be selected as Primary Care Physicians.
In order to be seen at Stanford Medicine Children’s Health, your Primary Care Physician must refer you and your medical group (SCCIPA), or health plan must authorize all services provided at Lucile Packard Children's Hospital Stanford or by Stanford Medicine 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.The following Primary Care Physicians (PCPs) are contracted through Santa Clara County IPA (SCCIPA)
Last First Ahmed, MD Amina Chadarevian-Zorian, MD Rita Del Signore, MD Claire Drucker, MD Bryan Griswold, MD Jenny Hayashi, MD Tomomi Hays, MD Tobias Hughes, MD Marybeth Kapoor, MD Jerina Li, MD Anqi Li, MD Virginia Varamini, MD Nadereh
All Other Employer Sponsored Group Plans
If your health plan is not included on the list of in-network plans, that means that Stanford Medicine Children’s Health most likely does not have a contract with your plan.
