Sansum Clinic
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Insurance Plans & Healthcare Networks

Sansum Clinic is pleased to be included in the individual exchange/non exchange network for Anthem Blue Cross. See our Frequently Asked Questions about Covered CA and other Insurance Exchange Networks. Please visit Anthem Blue Cross or http://www.coveredca.com/ for more information.

Sansum Clinic has established a hotline with information and answers to your questions about the Affordable Care Act (ACA) and Covered California.

Call Our ACA HOTLINE: (805) 898-3301

We accept Medicare, many Medicare Advantage Plans, Medicare Part D, CenCal Health Plans, many HMO plans, many PPO plans, some EPPO plans, some EPO plans, many Mental (Behavioral) Health Plans, some Vision and Eyewear Plans, and many Workers Compensation Plans. At each visit, you should:

  • bring picture identification and any insurance cards,
  • stop at the Registration desk,
  • update your registration information,
  • pay your co-payment, deductibles, and/or coinsurance at that time, and
  • provide insurance information from your health plan ID card

It is imperative that you also provide updated information to Sansum Clinic whenever:

  • You receive a new insurance identification card
  • You are assigned to another provider group (HMO) not affiliated with Sansum Clinic
  • You select a new primary care physician (PCP)
  • Your address, name, or phone number changes, and/or
  • If you are in an EPPO or EPO plan with no out-of-network benefits

Insurance plan coverages and contracts are always subject to change. So it's important that you get confirmation of plan details directly from the insurance company, your benefit administrator or your broker as is appropriate to find out if Sansum Clinic is a provider under your specific plan before making a decision.

 

Plan Types

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Exchange/Non-Exchange Individual Plan (EPPO)
  • Exclusive Provider Organizations (EPO)
  • Medicare Advantage Plans (HMO, PPO, Pharmacy, Resources)
  • Other Government Plans
  • Medi-Cal HMO Plans
  • Other Publicly-Funded Health Plans
  • Mental (Behavioral) Health Carveout
  • Workers CompensationEyewear and Refractions

Individual Medicare Plan Options

According to www.Medicare.gov, you may enroll in plans from October 15 to December 7 annually.

Medicare Options at Sansum Clinic:

  • AARP MedicareComplete Secure Horizons (formerly known as Secure Horizons by United Healthcare)
    Members: (800) 950-9355  Non Members: (800) 547-5514
  • Health Net Seniority Plus Ruby and Green
    Members: (800) 275-4737   Non Members: (800) 977-6738
  • For patients living outside of Santa Barbara County, we accept Anthem Medicare Preferred Standard PPO Plans (formerly known as Blue Cross Freedom Blue PPO)

Sansum Clinic recommends the following resources for assistance in understanding your Medicare options:

  • Health Insurance Counseling and Advocacy Program (HICAP) for free unbiased Medicare counseling
    www.cahealthadvocates.org/HICAP
    (800) 434-0222
  • The Official U.S. Government Site for Medicare and Center for Medicare and Medicaid Services
    www.Medicare.gov

Individual Exchange/Non-Exchange Plan Options

According to CoveredCA.gov you may enroll in plans from October 1, 2013 to March 31, 2014 initially, then annually thereafter from October 1 to December 15.

Individual Plan Options at Sansum Clinic:

  • Anthem Blue Cross - Exchange/Non-Exchange (narrow) Provider Organization (EPPO)

Sansum Clinic recommends the following resources for assistance in understanding your Exchange Plan options:

Health Plan Assistance

For assistance in understanding your health plan type, Sansum Clinic offers:

Health Resource Center
215 Pesetas Lane, First Floor
(805) 681-7672
Monday – Thursday 9:00 am to 4:00 pm
Friday 9:30 am to 12 noon
Or by appointment

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