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Health Plan Directory
Does Your Health Plan Offer World Class Choices?
To access the high quality medical care ValleyCare Health System offers right here in the Tri-Valley, here are a few questions you should ask: Does your employer offer a health plan that includes ValleyCare? Ask if your physician can refer you to ValleyCare for hospitalization? Ask if your physician can refer you to ValleyCare for outpatient services such as lab, radiology, or outpatient surgery? Can your primary care physician refer you to specialists at ValleyCare?

Because there are so many options in managed care plans, it is extremely important to look over your health plan choices carefully. You don't want to find yourself traveling long distances for health care when you need it.


If You Choose an HMO:
If you decide to select an HMO plan, be sure to choose a primary care doctor in the Affinity or Hill Physicians Medical Group. Affinity or Hill Physicians Medical Group physicians are affiliated with ValleyCare Health System and will allow you to receive the high quality care afforded by ValleyCare.

To access ValleyCare Health System's world class doctors and services, ask questions, do your homework and choose your physician and health plan with care.

For more information, please call the ValleyCare Health Information and Physician Network at (800) 719-9111.


Understanding Managed Care
Choosing a health plan during open enrollment is one of the most important decisions you will make this year.

It is helpful to understand the terms used in managed care, so we have provided you with a few explanations that we hope will help you in making this vital decision.

Managed Care is a term for many types of health coverage. To name a few:

HMO - health maintenance organization

PPO - preferred provider organization

POS - point-of-service

EPO - exclusive provider organization

HMO - requires you to obtain care from a specific list of physicians, hospitals or other healthcare providers. Your HMO may ask you to choose a primary care physician (PCP) who will determine where you will receive other physician or hospital services.

PPO - you may choose a provider who is not part of the Plan. If you do so, you will have to pay more out-of-pocket than if you go to a provider who is a part of the PPO.

EPO - Similar to HMO in which you must visit who is on its panel of providers. If you use an outside provider, the EPO will offer limited or no coverage for the office or hospital visit.


Contact:
Managed Care Contact at ValleyCare (925) 373-4079


ValleyCare Health System participates in the following Health Plans:

Aetna Healthcare of California, Inc.

  • Select Choice (HMO)
  • Open Choice (PPO)
  • Elect Choice (EPO)
  • Managed Choice (POS)
  • Worker's Compensation
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Alameda Alliance for Health

  • Medi-Cal HMO
  • Healthy Families
  • Alliance Complete Care
    (Medicare Special Needs Plan)
     
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BCE Emergis (MultiPlan)

  • PPO
  • EPO
 

Beech Street

  • PPO
  • Workers’ Compensation
     
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Blue Cross of California

  • California Care (HMO)
  • Prudent Buyer (PPO)
  • Blue Cross Plus (POS)
  • Freedom Blue (Medicare)
 

Blue Shield

  • Access Plus (HMO)
  • HMO Plus or POS
  • Select (PPO)
  • Preferred (PPO)
     
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CCN (Coventry)

  • PPO
  • EPO
  • POS
 

CIGNA

  • HMO
  • PPO
  • EPO
     
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CorVel

  • PPO
  • Workers' Compensation
 

Employee Health Systems

  • PPO
     
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FedMed

  • National Provider Network
  

First Health (Coventry)

  • Medical Network (PPO)
  • Select Network (EPO)
  • Workers’ Compensation
     
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Galaxy Health Network

  • PPO
  • Workers’ Compensation
 

Great-West Healthcare of California, Inc.

  • HMO
  • PPO
  • POS
     
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Health Net of California, Inc.

  • HMO
  • PPO
  • POS
  • Seniority Plus
  • Healthy Families
 

HPO, ltd. (Health Payors Organization)

  • PPO
     
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Humana

  • ChoiceCare (PPO)
  

Integrated Health Plan, Inc.

  • PPO
     
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Interplan Health Group

  • PPO
  • Workers’ Compensation
 

MultiPlan, Inc.

  • PPO
  • Workers’ Compensation
     
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PacifiCare

  • HMO
  • PPO
  • POS
  • Secure Horizons
  

Pacific Foundation for Medical Care (PFMC)

  • PPO
  • EPO
  • Workers’ Compensation
     
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Pacific Health Alliance

  • PPO
  

ppoNEXT (Concentra)

  • PPO
  • EPO
  • Workers' Compensation
     
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PHCS (Private HealthCare Systems)
(MultiPlan)

  • PPO
  • EPO
  • POS
 

Prudential

  • (See Aetna Healthcare of California)
     
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Three Rivers Provider Network

  • PPO
  • Workers’ Compensation
  

Tricare / TriWest

  • Tricare/TriWest Prime (HMO)
  • Tricare/TriWest Standard (PPO/POS)
  • Tricare for Life/TriWest (Medicare supplement)
     
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United Healthcare

  • Choice
  • Choice Plus
  • Options (PPO)
  • Select (EPO)
  • Select Plus (POS)
  

USA MCO (Managed Care Organization)

  • PPO
  • Workers’ Compensation
     
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Workers' Compensation Contracts

  • Access MPN (Medical Provider Network)
  • CompAmerica
  • Marriott MPN
  • Medex HCO
    
     
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