Recent changes in healthcare can confuse you about financing your medical care.  We help clarify these changes by detailing and reviewing the Affordable Care Act.  We aim to help you evaluate which health plans work best for you and your family.

Southern California Medical Gastroenterology Group will begin accepting Blue Cross PPO, Blue Cross EPO, Blue Shield PPO, and Health Net PPO.  You can access these plans through Bronze, Silver, Gold, or Platinum levels.  We also accepted PPO and EPO plants listed in the aforementioned tiers.

Our practice continues to accept Medicare and private PPO insurance plants.  We recommend you consult with your insurance company to determine if we are in-network with them.

The Affordable Health Care Act established the public health insurance exchanges marketplace  These were created to help individuals find and purchase health insurance plans and benefits.

What are health insurance exchanges?

Exchanges are an insurance marketplace where individuals and small businesses can make purchases of health plans.

Why were health insurance exchanges created?

They create an organized market for health insurance by offering a choice of plans, comparison of prices and rules, and creating a resource for information.

Will this marketplace replace buying private health insurance?

The exchanges present a new method of buying health insurance, not a substitute.

How are the exchanges organized?

The plants are organized through three ways.  A State-run facilitator model allows health insurance companies that meet minimum state and federal requirements to participate in the exchange. A state-run active purchaser model receives bids from health insurance companies and negotiates prices to be offered on the exchange.  A Federally-run model creates exchanges in states without an active one.

What benefits do the health plans on the exchanges cover?

Plans offer essential health benefits as defined by the ACA.  These include benefits from fields such as ambulatory patient services, emergency services, maternity and newborn care, mental health and disorders, hospitalization, behavioral health treatments, rehabilitative services, laboratory services, pediatric services, vision care, and prescription drugs.

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