We are contracted providers for the following PPO health plans:
-Anthem Blue Cross PPO (most plans)*
-Blue Shield of California (most plans)*
-Cigna PPO (most plans)*
-Fortified Provider Network
-Galaxy Health Network
-Health Management Network
-HealthNet PPO (most plans)*
-National Provider Network/Medavant
-Pacific Foundation for Medical Care
-Pacific Health Alliance
-Prime Health Services, Inc.
-Private Healthcare Systems (PHCS)
-Scripps Employee Medical Plan
*IMPORTANT for Blue Shield, Blue Cross, Cigna and HealthNet patients: We urge you to exercise caution when determining the provider network for your insurance, especially for non-employer sponsored plans. With the implementation of the Affordable Care Act and the public health insurance exchanges, there has been an incredible amount of confusion about the different products offered by each insurer. Blue Shield’s provider network has been especially confusing, as they have 12 different new plans that utilize different provider networks. Also, Cigna’s new “Local Plus” plans use a different provider network than their traditional PPO. In December 2017, HealthNet informed us that they have implemented a similar “narrow network” plan called “EnhancedCare”. We are NOT and will NOT be part of these “narrow” provider networks. Please contact your insurance directly to be certain that your Coast Pediatrics Del Mar or Carmel Valley pediatrician is in your provider network. Unfortunately, we are unable to answer these provider network questions and will direct you back to your insurance carrier.
*NOTE FOR 2018-2019 OPEN ENROLLMENT PERIOD: We have learned that HealthNet and Blue Cross are now offering the discounted “narrow provider network” plans as options for employer-sponsored plans (in addition to individually purchased plans). These plans will appear enticing due to their lower cost, but please be aware that Coast Pediatrics is NOT in network. Unfortunately, the insurers has given us no way to identify these plans by policy number, etc. Therefore we STRONGLY encourage you to research in advance with the insurer whether Coast Pediatrics is in network for the plan that you are considering choosing.
**NOTE for Qualcomm employees: Qualcomm has added the choice of “Qualcomm Premier PPO – Scripps” to insurance options for their employees. This is a health plan that exclusively uses Scripps primary care providers, therefore your Coast doctors will NOT be in network for this plan.