Health Insurance Plans (2024)

Whether you’re considering insurance through your employer or purchasing coverage on your own, we can help guide you through your different options so you can get the coverage you need.

Stanford Health Care is contracted with most major health insurance carriers. Coverage for your care at Stanford Health Care is determined by your insurance company and is based on the provisions of your specific plan.

To verify Stanford Health Care has in-network status for your plan, please look for your plan in the appropriate insurance category below. You may also want to contact your insurance provider directly to confirm Stanford Health Care's status. You may be asked for our group NPI or Tax ID.

Insurance Types

Please click on any of the insurance types listed below to find out our status with each of these plans.

  • Coverage Through Your Job
  • Covered California and Individual-Family Plans
  • CalPERS
  • Medi-Cal
  • Medicare
  • TRICARE and TriWest

If you are a UHA patient, visitUniversity HealthCare Alliance, dba Stanford Medicine Partnersfor insurance coverage.

If you or your child is a patient at Stanford Children's Health, visitStanford Medicine Children's Healthfor insurance coverage.

If you are a Stanford Health Care Tri-Valley patient, visit Stanford Health Care Tri-Valley.

Behavioral Health

  • Please be aware that visits with behavioral health professionals will be billed to yourbehavioral health/mental health insurance carrier.
  • Your behavioral health insurance (also called mental health insurance) may be different than your medical insurance which covers your medical treatment.

Understanding behavioral health/mental health insurance benefits:

  • Most insurance plans offer medical coverageandbehavioral health/mental health coverage, however, they may not always access the same network of providers. Your behavioral health insurance may access a “carve out” network or third-party insurer.
  • Your insurance plan network might have different provider or medical facility restrictions for behavioral health versus your medical care.
  • As a result of the potential different network restrictions covered by your behavioral health/mental health plan, your insurance plan might cover your medical treatment at Stanford Health Care, but not cover behavioral health services at Stanford Health Care.
  • This could be the case even if your behavioral health issues relate entirely to your medical treatment.
  • When you are referred to Stanford Health Care behavioral health services, our benefits specialists will determine your behavioral health coverage and associated network of providers and will discuss with you any limitations prior to being scheduled for a New Patient Visit.

What if I don’t have coverage?

  • If your behavioral health benefit plan will not allow you to be seen by a member of the behavioral health team, we encourage you to work with our Stanford Health Care social workers and your medical team to seek assistance in selecting a mental health provider who participates in your behavioral health network. You also have the option to seek services at Stanford Health Care outside of your behavioral health benefits as a self-payment status for which a patient financial counselor could further assist you in understanding those options.

If you do have behavioral health coverage for services at Stanford Health Care…

  • Many patients may require short term behavioral health care during their active treatment period.
  • Your specific care may require you to receive services more often, with additional follow up needed over time. We encourage you to take responsibility for understanding your ongoing benefit coverage; for example, the number of visits covered for counseling.
  • If your insurance company, benefits, or network restriction changes and for each new benefit year,you are encouraged to continue to make sure your insurance covers services at Stanford Health Care.
  • Our financial counselors and benefits specialists can help you to understand your insurance coverage as it pertains to seeking behavioral health care services at Stanford Health Care.

Financial Counseling

Financial Counseling is available to help you navigate the financial component of getting care at Stanford Health Care. As part of the Patient Access Services team, financial counselors are dedicated to serving as a resource to you and your family by:

  • Explaining your insurance coverage and benefits
  • Estimating your financial responsibility for services not covered by insurance
  • Identifying possible ways for you to pay for your care if you do not have adequate funds or health insurance
  • Helping you identify and obtain coverage for government programs, where available
  • Addressing questions or concerns regarding your insurance coverage and financial assistance

Reach a financial counselor at 844-498-2900 from Monday – Friday, 8:00 a.m. – 5:00 p.m. Financial counselors strive to make the financial concerns surrounding your care as stress free as possible, so you can focus on what is most important—your health.

Learn more»

Health Insurance Plans (2024)

FAQs

What are the 4 most common health insurance plans? ›

Preferred provider organization (PPO) plan. Health maintenance organization (HMO) plan. Point of service (POS) plan. Exclusive provider organization (EPO)

Is $200 a month good for health insurance? ›

Is $200 a month a lot for health insurance? The value of $200 per month for health insurance can vary based on individual needs and location. For some, especially those with employer-sponsored coverage or receiving subsidies under the ACA, $200 might seem high.

Which health insurance is the best? ›

Compare the Best Health Insurance Providers
CompanyAvailability
Blue Cross Blue Shield Best Overall36 states
Kaiser Permanente Highest Quality Plans8 states and the District of Columbia
Oscar Best Health Management Programs18 states
Aetna CVS Health Best for Same-Day Care12 states

What is the highest income to qualify for Obamacare? ›

The income range is $30,000 to $120,000 in 2024 for a family of four. (Income limits may be higher in Alaska and Hawaii because the federal poverty level is higher in those states.) The American Rescue Plan Act of 2021 also extended subsidy eligibility to some people earning more than 400% of the federal poverty level.

Is HMO or PPO better? ›

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Is health insurance worth it? ›

If you don't have health insurance, those stories can sure get you thinking, Do I need health insurance? The answer—yes! Health insurance has a reputation for being expensive and confusing, but it can also be the only thing standing between you and financial disaster if you ever need medical care.

Is $600 a month a lot for health insurance? ›

How much does health insurance cost in California? The average cost of health insurance in California is $600 per month in 2024. That's for a 40-year-old with a Silver plan. Bronze plans usually have cheaper rates, but they also have less coverage.

How much is Obamacare a month for a single person? ›

How much does the average person pay for Obamacare? Obamacare costs an average of $584 per month for a 40-year-old with a Silver plan. Your age affects your monthly rates. A 20-year-old pays an average of $443 per month for a Silver plan, while a 60-year-old pays an average of $1,240 per month, before subsidies.

Who has the lowest health insurance rates? ›

Please view our full advertiser disclosure policy. Kaiser Permanente is the cheapest health insurance company of 2024, according to our analysis. We evaluated health insurance companies based on cost, coverage options, NCQA quality rating and consumer complaints.

Is Aetna or United Healthcare better? ›

Each company has similar Medicare Star Ratings for the quality of its Medicare plans, though the overall Aetna Star Rating in 2023 is slightly higher than the average UHC Medicare Advantage plan star rating.

Who is the number 1 health insurance in the US? ›

Best health insurance companies of 2024

Kaiser Permanente: Best health insurance. Aetna: Best health insurance for young adults. Blue Cross Blue Shield: Best health insurance for the self-employed. UnitedHealthcare: Best health insurance provider network.

Which company gives best health insurance? ›

Best Health Insurance Companies in India 2024
S.NoCompany NameIncurred Claim Ratio (2022-23)
1.Acko General Insurance Co. Ltd.83.88
2.Bajaj Allianz General Insurance Co. Ltd.74.27
3.Cholamandalam MS General Insurance Co. Ltd.67.88
4.Future Generali India Insurance Co. Ltd.79.18
24 more rows

How does the middle class afford health insurance? ›

Employees typically pay only a portion of premiums out of pocket, with their employers paying the rest. In addition, middle-income families with employer coverage receive a tax subsidy averaging over $5,000, covering close to 40 percent of premiums.

Is healthcare.gov worth it? ›

Consumers who went on HealthCare.gov, compared plans, and selected the plan that best fit their health and financial needs paid 38 percent less per month on average than the consumers whose plans were automatically renewed. Plans purchased on HealthCare.gov are comprehensive and guaranteed to cover the essentials.

What disqualifies you from the premium tax credit? ›

A19. If you enroll in an employer-sponsored plan, including retiree coverage, that is minimum essential coverage you are not eligible for the Premium Tax Credit for your Marketplace coverage, even if the employer plan is unaffordable or fails to provide minimum value.

What are the 4 recommended type of insurance? ›

Four types of insurance that most financial experts recommend include life, health, auto, and long-term disability.

What are the four different forms of health care policy? ›

There are four basic designs healthcare systems follow: the Beveridge model, the Bismarck model, the national health insurance model, and the out-of-pocket model. The U.S. uses all four of these models for different segments of its residents and citizens.

What is the most common types of insurance? ›

The most common types of insurance coverage include auto insurance, life insurance and homeowners insurance. Insurance coverage helps consumers recover financially from unexpected events, such as car accidents or the loss of an income-producing adult supporting a family.

What are the four parts to basic health insurance coverage? ›

What are the 4 parts of Medicare?
  • Medicare Part A – Hospital Coverage.
  • Medicare Part B – Medical Coverage.
  • Medicare Part C – Medicare Advantage.
  • Medicare Part D – Prescription Drug Coverage.

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