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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Cedars Chooses Network by Metal Tier?

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Question: It is my understanding that individual carrier networks should mirror on and off the exchange as per previous posts. How do you then explain Cedar-Sanai hospital who is doing just that with their contract through Health Net and are specifying down to plan level what they are accepting.

Answer: My read on the Cedars’ statement below is that the Health Net network is broader and more inclusive at the Bronze and Catastrophic plan level than are other levels. This is not an on exchange / off-exchange issue.

From Cedars Sinai website; “If you choose to purchase your health insurance through the exchange and want the option of receiving full coverage for care provided by Cedars-Sinai Medical Center and its physicians, there are three Covered California plans that will work for you:

  1. Health Net Bronze PPO Plan (available to all)
  2. Health Net Catastrophic PPO Plan (available to people under the age of 30)
  3. Health Net Tribal PPO Plan (available to Native Americans and Alaska natives with certain income limitations)

1 Comment

In LA and Orange County, Health Net only offers their PPO plans (non-tribal) at the Catastrophic and Bronze tiers. At the Silver, Gold and Platinum tiers, Health Net ONLY offers an HMO options.

That means that Cedars is accepting the Health Net PPO options, but not their HMO options. This situation is similar to HOAG hospital in Irvine & Newport Beach.

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