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Health Plan

Health Plan Information

No Central California Physicians’ network offers more health insurance choices than Santé Physicians.

We contract with a wide array of HMO and PPO insurance carriers to give you and your family a wide range of affordable plans for your family care. Click to find a list of our HMO and PPO contracting partners, or call your family physician for a health plan recommendation.

Need help choosing a health plan? Check out information below, or ask your physicians’ office or call our Member Services department at (559) 228-5410. Remember, make sure your employer offers a health plan, which provides access to a Santé Physicians office to make sure you get the best care in the Central Valley.

What to Consider when choosing a plan:

  • Is my doctor on this health plan’s “physician panel”?
  • Is the hospital my doctor chooses to practice in on this health plan?
  • What benefits do I need?
  • Does this plan cover those benefits?
  • Do I have any prescriptions I am currently on? Are these prescriptions on the plan’s “formulary”?
  • Does the plan offer access to Wellness Classes?
  • Most Importantly – Can I see my Santé physician if I choose this plan?

Here are some terms you may need to know when choosing a plan:

HMO (Health Maintenance Organization) – The right HMO plan can offer you a better access to “health maintaining” practices, rather than just care for illness. Ask your Santé provider to recommend a plan, or check out our listing of health plan. HMO care will cost you almost nothing as long as you access a select panel of physicians and ancillary care facilities. Generally, your HMO will require you to pay “copay” when you visit our offices, please remember to bring your co-pay when you visit our office.

PPO – Preferred Provider Organization – Your PPO will generally require copay, as well as your HMO. Often PPO plans will offer a wider panel of providers than your HMO but will limit the amount of health maintenance programs covered by your plan.

POS – Point of Service Plan – An HMO, which gives you the opportunity to choose a physician outside your HMO panel at additional cost to you. These plans offer more choices, but generally cost you more money. Studies show that 98% of POS users use the HMO panel anyway, you may want to consider saving your money.

Indemnity Insurance – Insurance “the way it used to be.” With this insurance, your health plan will pay a percentage of your visit and you will pay the uncovered costs. This type of plan will cost you more if you access care, but will give you more choices in physicians and services.

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