You may get your health insurance through an employer, a spouse, partner, family member, local insurance agent or your state’s marketplace (Covered California).
We accept most health maintenance organization (HMO) and preferred provider organization (PPO) plans. We also have a large network of doctors across Southern California. So, if you move, or change jobs or insurance plans, you can continue to see an Optum doctor.
We accept the following health insurance plans. Visit each plan's website for more information.
Medi-Cal plan (California’s Medicaid program)
If you aren’t sure what type of health insurance plan you have, check your health insurance card. If you can’t find the information there, you can:
- Call your chosen Optum clinic to see if it accepts your health plan, or
- Call your health insurance company to find out if you can see an Optum doctor.
- Limited network
- Health plan only offers dual eligible/Cal MediConnect option(s) for Medicare Advantage patients. Does not offer Medicare Advantage-only option(s).
- Employer-sponsored plans only
- Fee-for-service only
- Available in Orange County only
- Available in San Diego only
There are several differences between a health maintenance organization (HMO) and preferred provider organization (PPO) plan. They differ in the size of the plan network, ability to see specialists, plan costs and coverage for out-of-network services. Also:
- Coordinate your care through a network of doctors and hospitals. You pick a medical network and one primary care doctor within that network.
- Your primary care doctor coordinates your care and works closely with the hospitals, specialists and other providers in your medical network.
- Your HMO plan usually won't pay for any visits to health care providers who are not in your medical network.
- Have a larger network of medical providers. This gives PPO patients more flexibility in choosing doctors.
- You don’t have to select a primary care doctor. You can go to any health care professional you want without a referral — inside or outside of your network.
- There are network benefits and out-of-network benefits. If you stay inside your PPO network, you’ll pay less for your medical services. If you go outside of your PPO network, you might have to pay more.
No, Optum is not an insurance plan. We are a group of doctors who contract with most major health insurance plans. These include HMOs, PPOs, Original Medicare, Medicare Advantage and supplement plans. These may vary by office location.
Call the office you want to go to and see if it accepts your health plan. You can also call your health plan and ask if you can choose an Optum doctor.OR
Your insurance plan may require a copayment at your doctor's visit. We also accept automatic bill pay, cash, checks, Visa, American Express, Discover and Mastercard.OR