It’s important that we have all of your insurance information at the time of scheduling your appointment. If you have a plan that requires authorization, please arrange for this before calling us. A copy of the authorization should be faxed to (310) 206-3649. If you have more than one plan, we will need information for all of your plans.
An HMO is a health maintenance organization.
PPO and POS plans are kinds of health plans. Like an HMO, these plans have provider networks, but you can choose to see doctors outside of the network and pay more.
PPO Plans
A PPO is a preferred provider organization. A PPO is good plan for people who want to see providers without prior approval from their health plan or medical group and who do not want to choose a primary care doctor.
POS Plans
A POS is a point of service plan. It is a mix between an HMO and a PPO.
UCLA is contracted with most major PPO plans, but if UCLA is not in network with your plan, you might not have coverage at all to come to UCLA. Additionally, some PPO plans do not cover both a professional and a facility fee.
Family PACT is a family planning program that helps eligible Californians avoid getting pregnant or causing a pregnancy when they are not ready.
Family PACT is a limited-benefits family planning program with four simple eligibility criteria:
Medi-Cal is health care for people with low or no income. Some people who have Medi-Cal are in a Medi-Cal Managed Care plan. These plans have networks of providers, including doctors, pharmacies, clinics, labs, and hospitals. You must use the providers in your network when you need health care. UCLA is usually not in your network, but you can still request authorization from your plan to get care here.
Your Primary Care Doctor
You will have one doctor or clinic that you go to first for most of your health care. The health plan may choose a doctor or clinic for you when you join the plan. You can change your doctor or clinic if you want. Call your plan and ask for a list of doctors and clinics.
Medi-Cal Benefits
Medi-Cal covers the basic benefits that all health plans cover. Medi-Cal also covers prescription drugs, vision care, and hearing care.
If You Have a Complaint
Presumptive Eligibility Medi-Cal
Presumptive Eligibility (PE) for Pregnant Women is a Medi-Cal program designed to provide immediate, temporary coverage for prenatal care to low-income pregnant women pending a formal Medi-Cal application.
Any woman who thinks she is pregnant, is a California resident, and whose family income is under a certain amount is eligible for Presumptive Eligibility (PE) for Pregnant Women. However, she must seek this care through a participating provider and they will determine if you are eligible for this program.
PE is a temporary Medi-Cal program that does not cover labor and delivery, or inpatient care. That is why it is important for PE patients to apply for Medi-Cal right away. PE Medi-Cal Program >
Medicare is a national health insurance program for:
Medicare Advantage is Medicare's managed care program. If you join Medicare Advantage, you get all your care through an HMO or PPO that has a contract with Medicare. The Federal Center for Medicare Services (CMS), not the California Department of Managed Health Care (DMHC), regulates Medicare Advantage plans. DMHC conducts initial licensure review and financial oversight on Medicare Advantage plans
Get Help from HICAP
HICAP is the Health Insurance Counseling and Advocacy Program. Anyone who has Medicare can get free help with forms, problems, and questions. Call HICAP at 1-800-434-0222 or visit the HICAP web site.
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