Options for Purchasing Individual Coverage

I Buy Health Insurance On My Own

If you purchase a private (also known as commercial) policy for yourself or your family, you have two options:

  • Purchase a plan through the Covered California health benefit exchange
  • Buy a private plan through an insurance agent or a health plan directly outside of the exchange

Either way, please choose your plan carefully to ensure you have full coverage for care from Cedars-Sinai Medical Center and our physicians.

Click below to review your options for coverage that include Cedars-Sinai. (We will continue to update this information as we receive additional details from the insurance companies.)

Open enrollment for 2017 has closed. You can’t enroll in a health insurance plan for 2017 unless you qualify for a special enrollment period, which is usually 30-60 days following certain life events that involve a change in family status (e.g., marriage or birth of a child) or loss of other health coverage. To learn more about reporting or qualifying for a special enrollment period, please visit the healthcare.gov marketplace or call the marketplace call center at 800-318-2596 (TTY: 855-889-4325).

Open enrollment for 2018 is Nov. 1, 2017, through Jan. 31, 2018. If you are changing plans, you will need to select a new plan by Dec. 15, 2017, to avoid a gap in coverage.


Financial Assistance

We offer a variety of financial assistance programs that can help our patients with out-of-pocket costs. These programs are available to a wide range of incomes.

Effective July 1, 2017, California has implemented consumer protection laws protecting patients from receiving “surprise bills” from physicians in certain circumstances when a physician is providing services at an in-network facility. If Cedars-Sinai is considered in-network and a physician is out of network and providing non-emergent services, unless receiving prior consent, the physician might be legally restricted in the amount he/she can bill patients beyond what a patient would expect under the terms of their commercial health plan. The law is complex, and there are several exceptions to the rules. If you have questions or complaints, please contact the California Department of Managed Health Care at 888-466-2219.

 

Coverage through the Covered California health benefit exchange:

Covered California health benefit exchange

If you purchase your health insurance through the Covered California exchange and want the option of receiving full coverage for care provided by Cedars-Sinai Medical Center and many of our physicians, you will need to choose:

  • Anthem Blue Cross EPO plans (all metal levels — e.g., Platinum, Gold, Silver, Bronze)
    • If enrolled, coverage will be good for 2017 only. Anthem will not offer coverage in Southern California counties in 2018.
    • You will have coverage for any in-network physician without a referral. Out-of-network providers are not covered — except for emergency or urgent care.
  • Blue Shield of California PPO plans (all metal levels — e.g., Platinum, Gold, Silver, Bronze).

None of the other plans in the Covered California health benefit exchange will allow you to receive full coverage for care provided by Cedars-Sinai Medical Center and our physicians in 2017. Please note that many health insurance companies will be offering plans both within and outside of the exchange, so be sure to compare carefully.

If you qualify for and choose to accept a subsidy from the federal government to help with your premium, you will be limited to the policies sold by Covered California. This is a more limited set of plans that generally have fewer hospitals and doctors in their networks.

Please note, emergency care provided at any emergency room – including Cedars-Sinai’s Emergency Department – is covered through all insurance plans, whether they are part of the exchange or not.

To learn more, visit www.coveredca.com or call 800-300-1506.

*Information updated Aug. 3, 2017.


 

Coverage purchased directly from an insurance company or through an insurance agent:

Anthem Blue Cross (Covers Cedars-Sinai in 2017)

All metal levels (e.g., Platinum, Gold, Silver, Bronze) of Anthem Blue Cross Exclusive Provider Organization (EPO) plans provide full coverage for care from Cedars-Sinai Medical Center and many of our physicians through 2017.

  • Cedars-Sinai Medical Center is offered as an in-network hospital in EPO plans.
  • You will have coverage for any in-network physician without a referral. Out-of-network providers are not covered — except for emergency or urgent care.
  • Anthem Blue Cross will not offer individual and family plans in Southern California counties in 2018.
  • If you have a grandfathered plan with Anthem Blue Cross that offers their full network of providers, you will be able to keep coverage under that grandfathered plan in 2018 as long as you continue to pay premiums under the plan. Grandfathered plans must have been purchased prior to March 23, 2010.
  • Please confirm plan participation with your physician or Anthem.

For more information on Anthem’s individual and family plans, call 866-249-4844 or visit Anthem’s website.

*Information updated Aug. 3, 2017.

Blue Shield of California PPO (Covers Cedars-Sinai)

All metal levels (e.g., Platinum, Gold, Silver, Bronze) of Blue Shield of California PPO plans provide full coverage for care from Cedars-Sinai Medical Center and many of our physicians.

Please confirm plan participation with your physician or Blue Shield. For more information, visit Blue Shield's website or call 1-888-626-6780.

*Information updated Aug. 3, 2017.

Health Net

Health Net does not offer individual and family plans in California.

*Information updated Aug. 3, 2017.

Aetna

Aetna does not offer individual and family plans in California.

*Information updated Aug. 3, 2017.

Cigna

Cigna no longer offers full-network plans. All new Cigna individual and family plans are Cigna's Local Plus Network that exclude the majority of Cedars-Sinai physicians.

*Information updated Aug. 3, 2017.

United Healthcare

United Healthcare is not offering plans to individuals in the Los Angeles area.

*Information updated Aug. 3, 2017.


For more guidance, click the option that best describes your situation.

I Get Health Insurance Through My Employer

I Buy Health Insurance On My Own

I Am Eligible for Medicare

I Am Eligible for Medi-Cal

I Am Eligible for BOTH Medicare and Medi-Cal

I Don’t Have Health Insurance