Insurance & Self-Pay Options

In-network insurance and self-pay options

Aetna

  • Open Access
  • Aetna Choice POS II

Anthem Blue Cross

  • PPO PRUDENT BUYER CLASSIC
  • CA SG ANTHEM PPO
  • SELF-FUNDED EXP HERITAGE
  • SELECT PPO NARROW NETWORKS
  • CA SG ANTHEM PPO
  • PPO PRUDENT BUYER CLASSIC
  • CA GENERIC HLTH SAVINGS ACCT
  • CDHP BC PPO LUMENOS HEALTH SAVINGS ACCOUNT

Blue Cross of California

  • PPO – Incentives
  • CDHP BC PPO LUMENOS HEALTH SAVINGS ACCOUNT

Blue Cross Blue Shield of California PPO

Blue Shield of California

  • Covered California
  • TRINET III BLUE SHIELD PPO 1500 FF
  • STANDARD
  • SILVER 70 PPO JAN20
  • ANTHEM SILVER PPO 2000/30% W/HSA – RXC
  • BRONZE 60 PPO JAN20
  • OKTA INC CUSTOM PPO NO NETWORK DEDUCTIBLE 15 100 5
  • SILVER 94 PPO JAN20
  • TRINET III BLUE SHIELD PPO 500 FF
  • STANFORD UNIVERSITY
  • ASO PSP 1750 FAMILY
  • SILVER 1950 PPO JAN20 (Covered California)

Blue Shield of California

  • Covered California
  • TRINET III BLUE SHIELD PPO 1500 FF
  • STANDARD
  • SILVER 70 PPO JAN20
  • ANTHEM SILVER PPO 2000/30% W/HSA – RXC
  • BRONZE 60 PPO JAN20
  • OKTA INC CUSTOM PPO NO NETWORK DEDUCTIBLE 15 100 5
  • SILVER 94 PPO JAN20
  • TRINET III BLUE SHIELD PPO 500 FF
  • STANFORD UNIVERSITY ASO PSP 1750 FAMILY
  • SILVER 1950 PPO JAN20 (Covered California)

Blue Shield Blue Cross Federal Employee Program (FEP)

Brown & Toland HMO

Cigna

Open Access Plus

Hill Physicians HMO

Medicare of Northern California

Multiplan Shared Savings

TriCare West

United Healthcare

  • Choice Plus – Commercial
  • CHOICE PLUS
  • OPTIONS PPO

Don’t see your plan? Give us a call.

No insurance? No problem! Call us to learn more about our available self-pay options.

Insurance FAQs

If your insurance card says:

  • Kaiser Hills
  • Physicians Network
  • Medi-cal
  • Medicaid
  • San Francisco Health Plan
  • Western Growers Insurance
  • TriCare East
  • Worker’s Compensation Claims
A premium is the amount of money you pay on a regular basis-once a month, four times a year, twice a year or once a year-to your insurance company to keep your health plan active. You can’t apply what you pay for your premium toward your deductible.

A coinsurance level is the percentage of money you have to pay out of your own pocket for covered services. It’s the portion of the bill not paid by your health plan after the deductibles have been reached.

A deductible is the amount of out-of-pocket expenses you have to pay each year before your health plan kicks in and starts paying for services.

An out-of-pocket limit is the total amount of money (not counting your premiums) you have to pay each year for your covered medical services. Your deductible and coinsurance payments for covered services count toward your out-of-pocket limit.

  • HMO – An HMO, or Health Maintenance Organization, is a type of health plan that offers a local network of doctors and hospitals for you to choose from. It usually has lower monthly premiums than a PPO or an EPO health plan. An HMO may be right for you if you’re comfortable choosing a primary care provider (PCP) to coordinate your health care and are willing to pay a higher deductible to get a lower monthly health insurance premium.
  • EPO – An EPO, or Exclusive Provider Organization, is a type of health plan that offers a local network of doctors and hospitals for you to choose from. An EPO is usually more pocket-friendly than a PPO plan. However, if you choose to get care outside of your plan’s network, it usually will not be covered (except in an emergency). If you’re looking for lower monthly premiums and are willing to pay a higher deductible when you need health care, you may want to consider an EPO plan.
  • PPO – A PPO, or Preferred Provider Organization, is a type of health plan that offers a larger network so you have more doctors and hospitals to choose from. Your out-of-pocket costs are usually higher with a PPO than with an HMO or EPO plan. If you’re willing to pay a higher monthly premium to get more choice and flexibility in choosing your physician and health care options, you may want to choose a PPO health plan.
No worries! Please give us a call at 415-390-6511 and we would be more than happy to help you out. We also offer very competitive self-pay rates if needed.
  • NO, if you have a PPO or EPO plan
  • YES, if you have an HMO plan.
  • YES, If you have:
    • Aetna Elect Choice Plan – please call 415-390-6511 for more information
    • Aetna Select Plan – please call 415-390-6511 for more information
    • Aetna Open Access Select – please call 415-390-6511 for more information
  • NO, if you have a PPO or EPO plan
  • YES. If you have an HMO plan, you must obtain a referral from your Primary Care Physician that you designated with your health insurance plan to see an orthopedic specialist.
  • YES. If your insurance plan requires PCP referrals (such as Aetna Elect Choice, Aetna Select, and Aetna Open Access Select).
  • If you are unsure whether a PCP referral is required by your health insurance plan, please call the Member Services Phone Number typically located on the back of your insurance card.
  • YES. Our self-pay rates are $270 for an office visit and $80 for an X-ray exam of 1 body part. Additional procedures and ortho equipment may add additional cost. If your appointment is with one of our surgeons, this price may not apply and charges may be higher. Call us at (415) 390-6511 for a quote.

Real Stories, Real Recovery.

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“Dr. Dickinson has been super helpful in my recovery and truly cares about the patient in getting back to full range of motion. Great team all around – I highly recommend!”

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