SUN HEALTH MEDICAL CLINIC

HEALTH INSURANCE

* PLAN TYPES

PREFERRED PROVIDER ORGANIZATION (PPO) PLANS

With PPO plans, no Primary Care Provider (PCP) is mandated, however it is important to have a PCP for optimal quality care and cost efficiency.  With PPO plans you can self refer and if you do, inform us so we can coordinate care and exchange information with the specialist.

HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS

MANAGED CARE

CLOSED TO NEW PATIENTS

OPEN TO ESTABLISHED PATIENTS

Managed Care health plans such as Health Maintenance Organizations (HMOs) require that you designate a Primary Care Provider (PCP) in an affiliated medical group.

If you are our established patient and have changed insurance with automatic assignment to another doctor, you may switch back to us.  As soon as you get your new insurance, call them because it takes time to for a PCP change to be effective.  If you call before the 15th of the month it will be effective the following month and if you call after the 15th of the month you have to wait until the 1st in 2 months.  For example, if you call 14 July it will be effective 1 August and if you call 15 July it will be effective 1 September.  PCP = Dr. Sunita Shailam in Mercy Physicians Medical Group

NO/OTHER INSURANCE

If you have Medi-Cal or Kaiser you should go through their network (however we evaluate still patients for Aviation or Immigration).  Otherwise, many others can still be a patient here.  If you have other insurance with Out of Network benefits, we charge up front, give you a receipt, and depending on the plan bill the insurance and if we receive payment will refund you.  Many of our patients visiting from out of the country have traveler's insurance that will reimburse them for the visit.

Fees

Health Insurance Agent