We are pleased to participate in the following individual ACA/Exchange plans: Anthem Blue Cross, Blue Shield of California, and Chinese Community Health Plan. Additionally, we participate with three SHOP (small group exchange) plans through Covered California: Anthem Blue Cross, Blue Shield of California, and Health Net.
Important Note for 2017: Many insurers have decided to leave the ACA Exchanges effective January 1, 2017. Starting in January, Anthem Blue Cross will not offer any PPO options on the exchange. Members who no longer have in-network coverage with One Medical are always able to pay for visits according to our fee schedule.
Important Note About Oscar Plans: One Medical is in-network with Oscar as part of the Hill Physicians network. We participate in both On-Exchange and Off-Exchange plans at our San Francisco and Burlingame offices.
Important Note About Health Net Plans: We are in-network with individual Health Net PPO plans (also known as "Off-Exchange" plans) provided outside of Covered CA. We are not in-network with individual Health Net EPO plans purchased through Covered California (referred to as "on exchange" plans.) Please call 415-523-6317 if you have any questions.
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.
At this time, One Medical is only in-network with ACA plans sold via the Health Insurance Marketplace, and we do not accept Off-Exchange or mirrored plans. For plans purchased privately (outside of an employer) through an insurance company, broker, or small business group, please be aware that if we are not in-network with their Exchange counterparts we may not be in-network with those plans. If you have any questions or concerns, please call us at 415-523-6317.
What is the difference between Exchange and Off-Exchange ACA plans?
An off-exchange plan is just an individual health insurance policy that is purchased directly from the carrier or through an agent or broker, outside of the state health insurance exchange. "On-exchange" refers to when an individual chooses a plan on the ACA's health insurance exchanges (marketplaces). The exchange is where individuals can compare policies, enroll in a plan, and receive a subsidy if they're eligible.
Pricing for common services are below; some services may not be listed.
|Primary Care — Initial Visit/New Issue
|Primary Care — Follow-up Visit
|Specialty Care — Osteopathic Manipulation — Initial Visit/New Issue
|Specialty Care — Osteopathic Manipulation — Follow-up Visit
|Specialty Care — Travel Health Consultation
|Specialty Care — Mental Health