Health Insurance Plans Accepted

Hoag Orthopedic Institute (HOI) is a unique hospital dedicated to the orthopedic patient. Our commitment is to restore, improve, and enhance the health and mobility of individuals with musculoskeletal conditions and diseases through excellence in care and outcomes, clinical innovation, research, and advocacy.

By participating in nearly every major health insurance plan and network, Hoag Orthopedic Institute makes it easy to afford the finest medical treatment available. (Updated as of 12/15/2021. Please verify your access with your Insurance Provider.)

• PPO (Preferred Provider Organization) Plans
• POS (Point of Service) Plans
• EPO (Exclusive Provider Organization) Plans
• HMO (Health Maintenance Organization) Plans
• Individual Senior Medicare Advantage Plans
• Other Senior Programs
• Covered California Insurance Plans
• Grandfathered Health Plans

PPO (Preferred Provider Organization) Plans

• Aetna Open Choice
  • Aetna Managed Choice
  • Aetna Managed Choice II
• Anthem Blue Cross
  • Prudent Buyer ¹
  • Blue Cross
  • Blue Cross Standard
• Blue Shield Individual/Family Plan - All medals (Gold, Silver, Bronze, etc.)
• CIGNA
• CIGNA Local Plus (My Flex Plan)
• First Health/Coventry Health*
• Great-West Healthcare
• Health Net
• Humana Choice Care
• Interplan/HealthSmart*
• MultiPlan*
  • Beech Street
  • PHCS
• United Healthcare

POS (Point of Service) Plans

• Blue Cross Plus
• Blue Shield
• CIGNA
• CIGNA Open Access Plus
• Great-West-Healthcare
• Healthnet ¹
• Pacificare Choice
• United Healthcare

EPO (Exclusive Provider Organization) Plans

• Aetna Elect Choice
• Cigna Local Plus EPO Plan

HMO (Health Maintenance Organization) Plans

Please contact your physician's office to confirm they accept your insurance plan. The list below reflects HMO plans accepted by Hoag Orthopedic Institute, not independent physicians' insurance. Access to HOI through an HMO plan is determined by the patient’s specialists having active medical rights at Hoag Orthopedic Institute and/or Hoag Memorial Hospital Presbyterian and being a part of the medical group you have selected. In order for a patient to have their treatment done at HOI. Please contact your insurance provider for more details.

• Aetna HMO
• Aetna Value Network
• Anthem HMO/POS
• Anthem Priority Select
• Blue Shield
  • Blue Shield TRIO
  • Blue Shield Net Value/Local Access
  • Blue Shield Save Net
• California Care (Anthem Blue Cross)
• CIGNA
• Cigna Select HMO
• Great-West Healthcare
• Health Net
• PacifiCare

Individual Senior Medicare Advantage Plans

• AARP Medicare Complete Secure Horizons Plan 2 (HMO) by UnitedHealthcare
• Aetna Medicare (PPO)
• Alignment Medicare AVA PPO
• Anthem Medicare Preferred Standard (PPO)
• Anthem Senior Select HMO
• Blue Shield 65 Plus (HMO)
• SCAN Classic, SCAN Balance, SCAN Heart First, SCAN Plus
• United Healthcare (including Focus)

Other Senior Programs

• Original Medicare Parts A & B
• Most Medicare Supplement Insurance (Medigap) plans
• Many Employer Group plans (Call the phone number on the back of your insurance I.D. card to verify if Hoag is your network hospital.)

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Covered California Insurance Plans

• Blue Shield PPO Bronze, Silver, Gold or Platinum Plans
• Blue Shield PPO Bronze Plans on Small Business Health Options Program (SHOP) Exchange
• Blue Shield Trio HMO

Grandfathered Health Plans

A grandfathered plan is an individual health insurance policy that was purchased - on or before March 22, 2010. Grandfathered plans provide the same access to the facilities and physicians you have grown accustomed to.

If you've had an Anthem Blue Cross or Blue Shield individual policy since March 22, 2010, you may be able to keep your current benefits through "grandfathering." Please call the member services phone number on the back of your insurance card to see if you qualify.

If you’ve had an Anthem Blue Cross or Blue Shield individual policy since March 22, 2010, you may be able to keep your current benefits through “grandfathering.” Please call the member services phone number on the back of your insurance card to see if you qualify.

*Hoag Orthopedic Institute does not participate in medical discount cards (cash pay) or consumer card programs such as Care Entrée’, Care IQ, Galaxy Health Network, Integrated Health Plan, MedicalConnect1, etc. that may be offered by these or any other networks.

^† For Private Healthcare Systems members, please check with your insurance plan to ensure you have Facility benefits through your health plan.

¹ These insurance plans will only be accepted by Hoag Orthopedic Institute until 12/31/2021.

The following plans are not contracted with Hoag Orthopedic Institute: Kaiser, Medi-Cal, and Three Rivers Provider Network (TRPN). In some cases, patients can access Hoag services if their plan and/or IPA pre-authorizes the care.

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