What Types of Plans Are Available to Me?

In most cases, you’ll have a choice between choosing a Health Maintenance Organization plan (known as an “HMO”) or a Preferred Provider Plan, also known as a “PPO.” Here are the main differences: With an HMO plan, you are required to choose a primary care doctor. Your doctor will manage most of your care needs, but if you ever need to see a specialist, your doctor must refer you to one. HMOs tend to be the most cost-effective option. With a PPO plan, you generally are not required to choose a primary care doctor. You are free to see a specialist without a referral. While there is more flexibility and choice in a PPO plan, they tend to be more expensive. You should be aware that even a PPO plan may have a defined network of preferred providers and cost you more if you see an out-of-network provider.

What Are Some Things to Consider When Choosing a Medical Plan?

Available Providers and Locations – If you and your family like using certain doctors or getting care in certain locations, make sure they are “in-network” for the plan you choose. You can verify this information from the health plan. If they are not “in-network,” you will have to pay more money out-of-pocket to continue seeing or using them. Cost – The amount you pay each month, aka your “premium” will vary depending on the plan you choose and the number of people who will be covered, such as your spouse and children. Also, pay attention to: Copays – which you have to pay each time you see a provider; and Deductibles – which is the amount you have to pay for covered services before your health plan begins covering your medical costs. Your copays generally do not count toward meeting your deductible requirement. Other Services Offered – Some plans offer expanded services such as virtual health, mental health services, and fertility services (if you’re looking to start a family). Make sure you fully understand all the resources offered by the plan you’re interested in.

Open Enrollment 2024 | MemorialCare

When You Choose MemorialCare, You Get Award-Winning Health Care

Now is the Time to Select a MemorialCare Primary Care Doctor During Open Enrollment 2023

Guarantee your access to five-star-rated care that includes Southern California’s best-known physician groups – MemorialCare Medical Group and Greater Newport Physicians – and leading hospitals. Get exceptional care from 300+ primary care providers, 12 urgent care centers and on-demand urgent care 24/7. Along with 2,000+ specialists at three adult U.S. News & World Report-recognized hospitals, a children's hospital and numerous outpatient specialty centers. Receive comprehensive care from dedicated professionals who are Called to Care.

MemorialCare Offers Expansive Health Care Services

300+ primary care physicians and 2,000+ specialists
Most HMO, PPO, EPO, POS and Medicare health insurance plans accepted
Convenient health centers, hospitals and urgent care centers throughout Orange County and Los Angeles County
Nationally-ranked and highly-specialized care, including:
MemorialCare Miller Children's & Women's Hospital - one of only eight free-standing children’s hospitals in California to have specialized maternity and pediatric care under one roof to meet all the unique needs of your family
Online scheduling, making it quick and simple to schedule an appointment with your doctor in person or virtually
We use myChart (Epic), the most commonly used electronic medical record system, which makes it easy to transfer records to your new MemorialCare doctor
Quality personalized care to best support you going forward

Selecting the Right Doctor for You

Ensure your access to every part of MemorialCare by selecting a primary care physician with us. Take these few easy steps after you select an insurance plan we accept.

Select a Health Plan with Access to MemorialCare

MemorialCare accepts most major health plans. Confirm the insurance plan you choose ensures access to MemorialCare.

Research and Select Your New Doctor

Find a MemorialCare primary care provider near you.

Find a Doctor

Notify Your Health Insurance

Call or visit your health insurance's website to notify them of your new provider. Then, call our Navigation Center, 24/7, at (855) 619-1107 or log into myChart to schedule your first visit.

Schedule Now

MemorialCare Accepted Health Plans

MemorialCare accepts most major HMO, PPO and EPO health plans, as well as Medicare, private indemnity and supplemental insurance plans. Visit your health insurance carrier’s website or call the number found on the back of your health insurance card to ensure your provider is in MemorialCare’s network. Applicable copayments and fees for services not covered by insurance are collected at the time of visit. We accept cash, personal check, and credit card (American Express, Discover, MasterCard, and Visa).

Aetna

Aetna Medicare Plus Plan (HMO)
Aetna Medicare Eagle Plan (HMO)
Aetna Medicare Prime II Plan (HMO)
Aetna Medicare Choice Plan (PPO)
Aetna Medicare Eagle Plus Plan (PPO)

Alignment Health Plan

My Choice/My Choice Cal Plus (HMO)
Platinum (HMO)
Heart & Diabetes (HMO C-SNP)
smartHMO (HMO)
Harmony (HMO)
ESRD Balance (HMO C-SNP)
CalPlus + Veterans (HMO)

Blue Shield

Blue Shield 65 Plus/Plus Group (HMO)
Blue Shield AdvantageOptimum (HMO)
Blue Shield Balance Plan (HMO)
Blue Shield Coordinated Choice (HMO)
Blue Shield Enhanced (HMO)
Blue Shield Inspire (HMO)
Blue Shield TotalDual Plan (HMO)
Blue Shield Vital (HMO)

Clever Care Health Plan

Longevity (HMO)
Jasmine (HMO C-SNP)
Fortune (HMO)
Value (HMO)

Health Net

Wellcare No Premium (HMO)
Wellcare Low Premium (HMO)
Wellcare Premium Ultra (HMO SNP)
Wellcare Dual Liberty (HMO D-SNP)
Wellcare Patriot Giveback (HMO)
Wellcare Assist (HMO)
Wellcare Dual Align (HMO D-SNP)

Humana

Humana Gold Plus/Value Plus/Emp HMO
Humana Honor HMO/PPO
Medicare PPO
Medicare PPO/Emp PPO Plus

SCAN

SCAN Affirm
SCAN Balance
SCAN Classic
SCAN Connections
SCAN Connections at Home
SCAN Heart First
SCAN Healthy at Home
SCAN Prime
SCAN Venture

TRICARE

TRICARE For Life

UnitedHealthcare Medicare

AARP Medicare Advantage Choice Plan (PPO)
AARP Medicare Advantage Freedom Plus (HMO-POS)
AARP Medicare Advantage Harmony (HMO-POS)
AARP Medicare Advantage Patriot (HMO-POS)
AARP Medicare Advantage Rebate (HMO-POS)
AARP Medicare Advantage SecureHorizons Focus (HMO-POS)
AARP Medicare Advantage Secure Horizons Premier (HMO-POS)
UnitedHealthcare Group Medicare Advantage (HMO/PPO)
UnitedHealth Chronic Complete (HMO-POS C-SNP)
UnitedHealth Chronic Complete Focus (HMO C-SNP)

Aetna

Aetna Choice® POS II (Open Access)
Aetna Select℠ (Open Access)
Aetna Value Network HMO (Bronze, Silver, Gold, Platinum)
Aetna Voluntary Plans
Aetna with Innovation Health Aetna Select/POS/PPO
AHF HMO
AWH Southern CA HMO (Bronze, Silver, Gold, Platinum)
AWH Southern CA Managed Choice POS/HDHP
AWH Southern California Managed Choice
AWH Southern California OA Aetna Select
AWH Southern California OA Elect Choice EPO/HDHP
Elect Choice® EPO (Open Access)
HMO (Bronze, Silver, Gold, Platinum)
HMO Deductible (Bronze, Silver, Gold, Platinum)
Managed Choice® POS (Open Access)
OA Elect Choice EPO (Bronze, Silver, Gold)
OA Managed Choice POS (Bronze, Silver, Gold, Platinum)
OA Managed Choice POS HDHP (Bronze, Silver, Gold)
OA Managed Choice POS/HDHP (Bronze, Silver, Gold)
Open Choice PPO (Gold)
QPOS® (Bronze, Silver)
Savings Plus Choice POS II
Savings Plus OA Managed Choice POS (Bronze, Silver, Gold, Platinum)
Savings Plus OA Managed Choice POS HDHP (Bronze, Silver, Gold)

Anthem Blue Cross

Advantage HMO/PPO
Anthem Blue Cross POS - HMO
Anthem High Performance (BlueHPN)
Blue Cross HMO (CACare) - (Indv, Sm, Lrg Grp)
California Care HMO
Dignity Health Central Coast EPO Network
Dignity Health Custom Advantage HMO
Dignity Health EPO/PPO
Dignity Health Ventura EPO/PPO
Lumenos Plans PPO
MemorialCare Custom PPO
National Blue High Performance Network (BlueHPN Non-Tiered, Tiered)
National PPO (BlueCard PPO Basic)
PERS Gold (Select PPO Preferred Providers)
PERS Select HMO/Traditional HMO
Prudent Buyer CA Only
Select EPO/HMO/PPO
Select PPO (PERS Select Providers)
Select PPO (Select Network)
Tenet Network PPO
Traditional PPO
UC CORE PPO
UC Care PPO
UC Health Savings Plan
UC High Option Supplement to Medicare
UC Medicare PPO (With/Without Prescription Drugs)
UC Resident and Fellows PPO
Vivity HMO
Pathway - HMO (On/Off Exchange)
Select HMO
UCSHIP PPO

Bind On-Demand Health Plan

Bind On-Demand Health Plan

Blue Shield of California

Access+ HMO (Bronze, Silver, Gold, Platinum) OffEx
Active Choice
Added Advantage HMO
Added Advantage PPO
Blue High Performance Network EPO
Blue Shield 0 Cost Share PPO AI-AN
Blue Shield 0 Cost Share Trio HMO AI-AN
Blue Shield Bronze 60 HDHP PPO/HDHP PPO AI-AN
Blue Shield Bronze 60 PPO/PPO AI-AN
Blue Shield Trio HMO (Bronze, Silver, Gold, Platinum)
Blue Shield Gold 80 HMO/Trio HMO/Trio HMO AI-AN
Blue Shield Gold 80 PPO/PPO AI-AN
Blue Shield Minimum Coverage PPO
Blue Shield Platinum 90 HMO/Trio HMO/Trio HMO AI-AN
Blue Shield Platinum 90 PPO/PPO AI-AN
Blue Shield Silver 70 HMO/Trio HMO/Trio HMO AI-AN
Blue Shield Silver 70 PPO/PPO AI-AN
Blue Shield Silver 73 PPO
Blue Shield Silver 73 Trio HMO
Blue Shield Silver 87 PPO
Blue Shield Silver 87 Trio HMO
Blue Shield Silver 94 PPO
Blue Shield Silver 94 Trio HMO
Blue Shield of California PPO Network
Full PPO OffEx (Bronze, Silver, Gold, Platinum)
Full PPO Savings OffEx (Bronze Silver Gold) Indv, Family
Tandem PPO (Bronze, Silver, Gold) OffEx
Trio HMO OffEx (Bronze, Silver, Gold, Platinum)
CCPOA Medical Plan
CalPERS Access+ HMO
CalPERS Trio
County of San Bernardino Shield Signature
EPO Full PPO/Tandem PPO
Federal Employee Health Benefit Program Access + HMO
Full PPO Savings HDHP OffEx Gold (Indv, Family)
Tandem PPO Savings OffEx (Bronze, Silver, Gold) Indv, Family
PPO/PPO Savings
Premier PPO
Shield Spectrum PPO
Silver PPO/HDHP PPO
Trio ACO HMO OffEx (Silver, Gold, Platinum)
Virtual Blue Tandem Bronze Gold PPO OffEx
Virtual Blue PPO

Boeing

MemorialCare Health Alliance for The Boeing Company

Centivo

Centivo

CalOptima (Not at all locations-Call entity to verify)

CalOptima (Only accepting patients age 18 and under)
United Care Medical Group (Only accepting patients age 18 and under)
CalOptima Care Network (WE DO NOT PARTICIPATE IN THIS PLAN)

Cigna

So. CA HMO/HMO POS Network
LocalPlus, LocalPlus HDHP, LocalPlus IN
Open Access Plus, Open Access Plus Tiered
Open Access Plus with Carelink, OA Plus Tiered with Carelink
So. CA Value/Select*
PPO, PPO HDHP, PPO Tiered
EPO, EPO HDHP

Coventry

Coventry National Network

First Health

First Health PPO

Health Net

Blue & Gold HMO
HMO - ExcelCare Network Medicare COB
HMO - ExcelCare Sm/Lrg Grp
HMO - Full Network Lrg Grp
HMO - Full Network Sm Grp (Platinum, Gold, Silver, GF Plans)
HMO - Medicare COB
HMO - Salud HMO Plus Lrg Grp
HMO - WholeCare Sm Grp (Platinum, Gold, Silver)
POS - Elect Lrg Grp
POS - Elect Open Access ExcelCare Sm/Lrg Grp
POS - Elect Open Access Medicare COB
POS - Elect Open Access Sm/Lrg Grp
POS - Medicare COB
POS - Select Medicare COB
POS - Select Sm/Lrg Grp
PPO – Ambetter PPO IFP (Platinum, Gold, Silver, Bronze, Min Cov, HDHP) On/Off Exchange
PPO - Lrg/Sm Grp (Platinum, Gold, Silver, Bronze, GF Plans, HSA Compatible, HDHP)
Stanford Student Dependent PPO
Stanford Student EPO/PPO
AON California PPO (Bronze, Bronze Plus, Silver)
AON California PPO (Platinum)

Multiplan/PHCS

Kaiser Permanente Insurance Company

Premier Physician Alliance

Whole Foods Employees
Adventist Health Hospital Employees

Medicare

Medicare Supplement Plans

MemorialCare Select Health Plan (Formerly Seaside Health Plan)

Alignment Health Plan HMO (Accepted only at Los Altos, Spring Street and Torrance locations)
Anthem Blue Cross HMO (Accepted only at Los Altos, Spring Street and Torrance locations)
Blue Shield HMO (Accepted only at Los Altos, Spring Street and Torrance locations)
LA Care HMO (Accepted only at Los Altos, Spring Street and Torrance locations)
MemorialCare Select Plan (Accepted in Greater Long Beach area and Orange County)
MemorialCare Select Health Plan (Accepted only at Los Altos, Spring Street and Torrance locations)

TRICARE

Tricare Prime/Prime Remote
Tricare Reserve Select
Tricare Retired Reserve
Tricare Select
Tricare Young Adult Prime/Prime Remote/Select

UnitedHealthcare

Charter, Charter Balanced, Charter Plus
Charter HMO, Charter Balanced HMO, Charter Plus HMO, Charter Plus
Choice, Choice Advanced, Choice HMO, Choice HMO Advanced
Choice Plus, Choice Plus Advanced, Choice Plus HMO Premier, Choice Premier
Doctors Plan/Plan Plus
Doctors Plan HMO, Plan Plus HMO
Heritage Plus/Heritage Select Advantage
Heritage Select EPO/POS/HMO
Options PPO
Passport Connect Choice, Choice Plus,
Select, Select Plus
Select Premier, Select Plus Premier
SignatureValue Advantage HMO
Signature Alliance HMO
SignatureValue Alliance HMO (CalPers)
SignatureValue Alliance HMO (CS VEBA)
SignatureValue Harmony HMO
SignatureValue HMO
Signature Performance HMO - Network 1-3
UHC Freedom EPO/PPO

Blue Shield of California

Accepted Individual and Family Plans “On Exchange” (Covered CA) and “Off Exchange” Sold Directly by Blue Shield
Blue Shield $0 Cost Share EPO AI-AN
Blue Shield $0 Cost Share PPO AI-AN
Blue Shield Bronze 60 EPO
Blue Shield Bronze 60 EPO AI-AN
Blue Shield Bronze 60 HSA EPO
Blue Shield Bronze 60 HSA EPO AI-AN
Blue Shield Bronze 60 HSA PPO
Blue Shield Bronze 60 HSA PPO AI-AN
Blue Shield Bronze 60 PPO
Blue Shield Bronze 60 PPO AI-AN
Blue Shield Gold 80 EPO
Blue Shield Gold 80 EPO AI-AN
Blue Shield Gold 80 PPO
Blue Shield Gold 80 PPO AI-AN
Blue Shield Minimum Coverage EPO & PPO
Blue Shield Platinum 90 EPO
Blue Shield Platinum 90 EPO AI-AN
Blue Shield Platinum 90 PPO
Blue Shield Platinum 90 PPO AI-AN
Blue Shield Silver 70 PPO
Blue Shield Silver 70 PPO AI-AN
Blue Shield Silver 73 EPO
Blue Shield Silver 73 PPO
Blue Shield Silver 87 EPO
Blue Shield Silver 87 PPO
Blue Shield Silver 94 EPO
Blue Shield Silver 94 PPO

Health Net

Covered California: HealthNet PPO Plans – Small Group
Health Net Enhanced PPO

MemorialCare Select Health Plan

MemorialCare Select Medi-Cal Products (Only for Sports Medicine Specialty Care)

UnitedHealthcare (WE DO NOT PARTICIPATE IN PLANS)

UnitedHealthcare Platinum (name may include HMO), a multi-state from Arizona (WE DO NOT PARTICIPATE IN THIS PLAN)

FAQs About Open Enrollment? We're Here to Help

Navigating open enrollment can be confusing. Don't worry, we're here to guide you through the process. Find answers to frequently asked questions below.

Open enrollment is a short period that occurs annually when one can choose a new medical plan or make changes to an existing plan for themselves and their families.

If you get your health insurance through your workplace, your employer will set the dates of your open enrollment period. Usually, it occurs in the fall, with your new plan starting in January of the following year.

If you are on Medicare, your annual enrollment period is October 15 to December 7 every year.

For Covered California, the open enrollment period generally occurs from November 1 through the end of January the following year.

You are generally locked into the plan you selected for you and your family for the year unless you have a qualifying event. A qualifying event is a unique situation in your life that allows you to change your benefits. Examples of qualifying events include a change in employment status and changes in family status (like marriage, divorce, birth of a new child and other things).

In most cases, you’ll have a choice between choosing a Health Maintenance Organization plan (known as an “HMO”) or a Preferred Provider Plan, also known as a “PPO.” Here are the main differences:

With an HMO plan, you are required to choose a primary care doctor. Your doctor will manage most of your care needs, but if you ever need to see a specialist, your doctor must refer you to one. HMOs tend to be the most cost-effective option.
With a PPO plan, you generally are not required to choose a primary care doctor. You are free to see a specialist without a referral. While there is more flexibility and choice in a PPO plan, they tend to be more expensive. You should be aware that even a PPO plan may have a defined network of preferred providers and cost you more if you see an out-of-network provider.

Available Providers and Locations – If you and your family like using certain doctors or getting care in certain locations, make sure they are “in-network” for the plan you choose. You can verify this information from the health plan. If they are not “in-network,” you will have to pay more money out-of-pocket to continue seeing or using them.
Cost – The amount you pay each month, aka your “premium” will vary depending on the plan you choose and the number of people who will be covered, such as your spouse and children. Also, pay attention to:
- Copays – which you have to pay each time you see a provider; and
- Deductibles – which is the amount you have to pay for covered services before your health plan begins covering your medical costs. Your copays generally do not count toward meeting your deductible requirement.
Other Services Offered – Some plans offer expanded services such as virtual health, mental health services, and fertility services (if you’re looking to start a family). Make sure you fully understand all the resources offered by the plan you’re interested in.

Patients Love Our Doctors!

Gina D.

Dr. Hassan is a wonderful doctor, who helped me through a very aggressive treatment plan for my breast cancer. I trust her judgment 100%. Not only is she an expert at her job, but she is also very kind, caring, cheerful, supportive and understanding. I would highly recommend her to anyone who needs a good oncologist.

Tin L.

We love Dr. Alfonso! We originally had another doctor from a different medical group, but every time we went for our baby's checkup, we felt rushed. We decided to try another doctor and found Dr. Alfonso. She takes her time with every appointment and answers all your questions with a smile. She comes highly recommended!

Kristen B.

The nurses took great care of my baby at MemorialCare Miller Children's & Women’s Hospital (especially Vartha, Luiza, Kathryn and Katie). My 2-month-old was transferred here with the RSV virus, and while it was a really scary experience, they were cautious with releasing her. I felt the doctors were warm, engaging and provided timely updates.

Are You 65 or Older? Learn About Your Options with Medicare

Medicare is a national health insurance program. You’re entitled to Medicare if you’re at least 65 and a U.S. citizen, or a permanent legal resident for the past five years. Medicare also covers some disabled people under age 65. People who receive Social Security disability insurance usually become eligible for Medicare after being disabled for 2 years consecutively.

Learn About Your Options

Sign-Up for a Free Medicare Seminar

Put Your Health in Caring Hands this Open Enrollment

Learn more about what open enrollment is and get answers to frequently asked questions such as the differences between HMO's and PPO's, what to consider when choosing a plan and more!

Learn More