Orthopaedic Specialty Institute, South Orange County Orthopaedics and Sea View are contracted with most major health insurance carriers and HMO networks. Please call your insurance company and ask if you have access to health care services at Orthopaedic Specialty Institute, and what (if any) co-payments, co-insurances, and deductibles will be your responsibility. Co-payments are due at the time of your appointment.
This list is not all-inclusive, is updated periodically, and may be subject to change. This list is not a guarantee of network participation with any payer.
Our office is contracted and in-network with the following plans:
Aetna
Aetna Standard Network, Aetna Medicare Advantage & Mail Handlers: If you have Aetna Standard Network, our office is in-network for all facilities and physicians.
We are not in-network with Aetna Aexcel Designated, Savings, Whole Health, or Premier plans.
Alignment Medicare/Anthem Blue Cross
Anthem Blue Cross Prudent Buyer PPO/EPO, Anthem Medicare Advantage: If you have one of these plans, our office is in-network for all facilities and most providers.
We are not in-network with Anthem Select, PersGold, or High-Performance Network plans.
Blue Shield
Blue Shield PPO/EPO Exchange & Off Exchange, Blue Shield Medicare Advantage, Blue Shield Federal: If you have one of these plans, our office is in-network for all facilities and most providers.
We are not in-network with Blue Sheild Tandem, Promise, or High-Performance Network plans.
Blue Cross Blue Shield (out of state)
Blue Cross Blue Shield (out of state): Our office facilities and physicians are in-network with out of state Blue Cross Blue Shield plans as long as the plan uses the BlueCard network.
Please check with your benefits department or call BlueCard Access at 800-810-BLUE (2583) to verify that your plan covers services at Orthopaedic Specialty Institute before scheduling your visit.
Cigna
Cigna PPO/OAP, Cigna Local Plus: If you have one of these plans, our office is in-network for all facilities and providers.
First Health Network/Health Net
Health Net PPO Exchange & Off Exchange, Purecare HSP/EPO: If you have one of these plans, our office is in-network for all facilities and providers.
We are not in-network with Health Net Enhanced or Community Care plans.
HMO Plans
Our office participates in the following HMO Networks:
- St Joseph Health
- St. Jude
- Mission
- St Mary/High Desert
- Premier
- Hoag Physician Partners
If you have an HMO plan, you will require a referral and authorization from your primary care physician to our office.
Medicare
If you have Medicare, our office is in-network for all facilities and providers.
Oscar
Please note, effective January 1, 2024, Oscar Insurance has left California. We are not in-network with any Oscar plan.
United HealthCare
United HealthCare PPO, Student Resources, United HealthCare Medicare Advantage, OptumCare Medicare Advantage, AARP Medicare Advantage, DEHA: If you have one of these plans, our office is in-network.
Workers’ Compensation
Our providers review each workers compensation injury on a case-by-case basis. If you have a workers’ compensation injury, please contact our office.
Please note that work-related injuries are typically not covered by your private or commercial insurance. If you want to be seen for a work-related injury without workers’ compensation, there is a chance that your insurance may deny coverage and you could be financially responsible for your visit.
