The Health Insurance Marketplace (aka health insurance exchanges) facilitates the purchase of health insurance in every state in accordance with the Patient Protection and Affordable Care Act (ACA). These exchanges provide a place for health insurance companies such as Blue Cross to sell insurance plans directly to consumers, and where consumers can price compare insurance plans by insurer and/or plan type.
A core principle of the ACA is that people will be healthier if they have access to affordable insurance coverage and high-quality primary care, which is why the federal government has mandated creation of these exchanges in every state.
Many people are still confused about how health insurance exchanges work; according to a recent poll by the Kaiser Family Foundation, 45 percent of Americans say they still don’t have enough information to understand the impact the ACA will have on their family.
To reduce the confusion, One Medical Group is committed to arming you with the information you need to make smart decisions. To that end, here are answers to a few of the most frequently asked questions we hear about One Medical and the Health Insurance Marketplace.
Which exchange plans does One Medical participate in?
One Medical is currently in-network with a number of different exchange plans. We’ll continue to expand this list over time, and update this page with the latest plans.
Blue Cross Blue Shield of Massachusetts
Harvard Pilgrim Health Care
Tufts Health Plan
California – Northern
- Anthem Blue Cross
- Health Net
- Blue Shield
California – Southern
Anthem Blue Cross
BlueCross BlueShield of Illinois
- Blue Cross Blue Shield of Arizona
- Health Net
CareFirst BlueCross BlueShield
How does One Medical Group choose which exchange plans to participate in?
We participate with exchange plans that provide us with the best opportunity to provide the high level of care and service you expect from One Medical. Our goal is to participate with as many plans as possible, and we expect to continue to expand the list of participating plans over time.
How do I work with One Medical if my exchange plan isn’t listed here?
If you don’t see your exchange plan listed here, we will do all we can to continue to provide you top-quality care. We offer reasonable out-of-pocket payment options, and depending on your insurance coverage, you may be able to submit these out-of-pocket expenses for reimbursement. Please contact your local One Medical office for more information.
How do the ACA plans compare to my current coverage?
Within each state’s exchange there are a number of insurance plans that vary by cost and benefit level. You’ll need to carefully review the offerings to find the premiums and level of coverage that are right for you. You may also wish to make sure your preferred physicians and hospitals are in-network with the plan you’re considering: Not all physicians and hospitals are included in each exchange plan. In addition, keep in mind that coverage can differ by plan, even if the insurer is the same. For example, an exchange product might not offer the same coverage as other plans under the same insurer.
How can I get more information about health insurance exchanges?
Each state’s exchange has a customer service center to assist you, and each state also offers official “Navigators” and enrollment counselors who can help you select coverage. In addition, licensed agents or brokers can also assist you if they are registered with the exchange in their state.
Here’s more information for the Health Insurance Marketplaces for each state or region where One Medical currently practices:
Service Center: 877-623-6765
One Medical Group: 617-903-5000
Service Center: 800-300-1056
Enrollment Counselors and Other Resources
One Medical Group: 415-578-3100 (Bay Area)
One Medical Group: 323-305-7150 (Los Angeles)
Service Center: 866-311-1119
One Medical Group: 312-219-2230
Service Center: 855-355-5777
One Medical Group: 212-530-0624
Service Center: 855-889-4325
One Medical Group: 602-218-4077
Service Center: 855-532-5465
One Medical Group: 202-660-0005
In addition to the state Marketplaces, two privately run online resources we’ve found particularly helpful are ehealthinsurance and Health Sherpa. Both sites offer free assistance for consumers to shop and compare premiums, subsidies, and coverage for health insurance in all 50 states.