How to Find a Doctor that Takes Your Covered California Health Plan

Today’s San Francisco Gate has an article about some of the challenges newly insured Covered California consumers are faced with finding a doctor or hospital that will take their plan.    Now that people have started to seek medical care with their new Covered CA health plan, many are running into roadblocks finding the doctors and specialists they want.   Unfortunately, the provider search tool on Covered California’s website, is no longer accessible from the home page and through no fault of their own, often contains inaccurate and outdated information.

Calling the doctor’s office to find out if they accept your health plan under Covered California doesn’t always work either.  Many doctor offices don’t know themselves which Covered California plans they do or don’t accept.   The health plans have created new networks for 2014 and many doctors are unfamiliar with the new plan networks.  Just because a doctor’s office accepts Health Net, for example, does not mean that they take the Health Net Community Care HMO network offered through Covered California.  The doctor’s office may take only the Health Net PPO plan that is offered only at the Bronze level in Covered California or the Silver, Gold and Platinum level outside of Covered California’s exchange.  To make things more complicated, they may take employer-group Health Net HMO plans but not individual or Covered California Health Net HMO plans.

The best way to search for your doctor, specialist or hospital is to use the carrier’s online directories, or provider finders. These online directories are not always accurate, but do provide the most up-to-date information available.  This does require, however, that you search for each doctor, specialist or hospital online with each individual carrier.  Searching for health plan provider links sometimes leads to broken links, and once you do find the provider search tool, you are often faced with a myriad of plan types, networks and/or sub-plans to select from.   If you don’t select the correct Covered California plan and corresponding network, you may be searching the wrong plan.  Calling the health plan directly hasn’t been working that well either.  The health plans have been overwhelmed with calls and many people are reporting long hold times to get through.

Already selected a Covered California health plan and your doctor doesn’t accept it?

Don’t fret.  You have until March 31, 2014 to change plans.  If you have already enrolled with a Covered California health plan and want to find a health plan that includes your doctors, specialists and hospitals call an Affordable California health plan specialist at 800-788-2197 or complete our help form and include the names of your docs and we’ll find you the right plan and handle all of the paperwork with Covered California to get you enrolled in the new health plan, at no charge to you.

Affordable California’s staff include Covered California certified insurance agents that are trained to assist consumers navigate through the new state health insurance exchange created by the Affordable Care Act.   Covered California certified insurance agents are required to undergo 12 hours of training and pass a state exam in order to represent Covered California health plans.
Please note this site is not maintained by or affiliated with Covered California, and Covered California bears no responsibility for its content.  The email addresses and phone numbers that appear throughout this site belong to Healthy Halo and cannot be used to contact Covered California.  












AUTHOR - Ali Nagy