Medi-Cal Acceptance: John Muir Hospital's Stance

John Muir Health is an integrated system of doctors, hospitals, and other services that provides high-quality patient care. The health group has financial assistance programs for uninsured patients and those who cannot qualify for State healthcare programs such as Medi-Cal. While John Muir Health is not a contracted provider with any State Medicaid program, it does accept the fee schedule as payment for individuals enrolled in the Medi-Cal program who receive outpatient emergency services.

John Muir Health accepts Medi-Cal for outpatient emergency services

John Muir Health is an integrated system of doctors, hospitals, and other services that provides high-quality patient care. While John Muir Health does not contract with any State Medicaid program, it does accept the fee schedule as payment for individuals enrolled in the Medi-Cal program who receive outpatient emergency services in the emergency department at one of their hospitals.

John Muir Health offers a Patient Financial Assistance Program to help patients with their hospital bills. Uninsured patients who have received services at their hospitals are offered a substantial discount off the billed charges. They also offer extended payment plans that are interest-free and can be set over longer periods of time.

John Muir Health partners with most major health plans, including:

• Aetna
• Anthem Blue Cross
• Blue Shield of California
• CIGNA
• Health Net
• United Healthcare

They accept most major health insurance plans, including HMOs, PPOs, and Medicare. However, it is important to note that their Walnut Creek and Concord Campuses are not contracted providers for Kaiser PPO and POS members through MultiPlan/PHCS. Kaiser PPO and POS members who receive treatment at these hospitals do so on an out-of-network basis and are responsible for the full billed charges.

Uninsured patients are offered a discount on billed charges

John Muir Health does offer a discount to uninsured patients who have had services at one of their hospitals. This discount is reversed if the Patient Financial Assistance Program is applied and approved. The discount also does not apply if the patient is enrolled in the Medi-Cal program and receives outpatient emergency services in the emergency department.

The Patient Financial Assistance Program is a program that helps patients pay all or part of their hospital bills. Qualification for the program, as well as the amount covered, is based on household income and assets. Extended Payment Plans are offered at any time and are interest-free. These plans can be set up to be paid in three separate payments, at regular intervals no more than 30 days apart. If patients need to make payments for longer than the no-interest window, the extended payment plan can be set over longer periods.

In 2016, a class-action lawsuit was brought against John Muir Health by uninsured patients who claimed they were charged inflated medical bills. The settlement, which was yet to be finalized by a judge, would make nearly 53,000 uninsured patients eligible for a refund or discounted bill. The refunds or discounts would equal 40% of charges at the Walnut Creek hospital and 50% at the Concord hospital. Only uninsured people with household incomes of less than $250,000 a year would qualify. As part of the settlement, John Muir Health also agreed to establish policies so that uninsured patients pay rates comparable to those with private insurance.

Basic Health Care (BHC) is another program offered through Contra Costa County. This program is for low-income adults who do not qualify under Medi-Cal or other state healthcare programs. While BHC does not cover any bills for services at John Muir Health hospitals, it will give patients access to services at Contra Costa Regional Medical Center for any follow-up or additional care.

Kaiser PPO and POS members are treated on an out-of-network basis

John Muir Health is an integrated system of doctors, hospitals, and other services that provides quality patient care. The organisation accepts most major health insurance plans, including HMO's, PPO's, and Medicare.

John Muir Health is not a contracted provider with any State Medicaid program, however, it does accept the fee schedule as payment for individuals enrolled in the Medi-Cal program who receive outpatient emergency services in the emergency department. John Muir Health also provides onsite eligibility services at no cost to help patients qualify for the Medi-Cal program.

It is important to note that PPO members do not need to enter a provider ID when enrolling in a PPO plan. However, it is recommended to call the doctor's office to confirm they are accepting new patients and verify that they have a contract with the PPO plan. Kaiser PPO members can call the Customer Service line, found on the back of their ID card, to determine if their physician has a contract with the PPO.

John Muir Health offers a Patient Financial Assistance Program for uninsured patients, providing a substantial discount off the billed charges. Extended Payment Plans are also available, with interest-free options for payments made within 30 days and longer-term payment plans for continued payments.

Contra Costa County offers Basic Health Care for low-income adults

Contra Costa County offers Basic Health Care (BHC), a healthcare program for low-income adults who reside in the county and do not qualify for Medi-Cal or other state healthcare programs. This program ensures that eligible residents have access to essential medical services, regardless of their documentation status.

BHC enrollees can receive medical care at the Contra Costa Regional Medical Center or at various Health Centers located throughout Contra Costa County, including select community clinics. This program does not cover bills for services at John Muir Health hospitals directly, but enrollees can utilize these facilities for follow-up or additional care after receiving initial treatment at the designated BHC-covered facilities.

To qualify for BHC, residents must have incomes below 300% of the federal poverty level. Additionally, enrollees cannot be members of an HMO or PPO health insurance plan. The program operates on a sliding-scale payment system, with enrollees paying a quarterly premium of up to $20 per month, depending on their income. This results in a maximum annual cost of $240 for adults aged 19 and above, and $60 for those aged 18 and under.

John Muir Health, an integrated system of doctors, hospitals, and other healthcare services, does not have a direct contract with any State Medicaid programs, including Medi-Cal. However, they do accept the fee schedule as payment for individuals enrolled in Medi-Cal who receive outpatient emergency services in their emergency departments. John Muir Health also provides onsite eligibility services at no cost to help patients qualify for the Medi-Cal program.

John Muir Health partners with major health plans, including Anthem Blue Cross and Cigna

John Muir Health is an integrated system of doctors, hospitals, and other services that provides the highest quality patient care every day. It works with most major health plans, including HMOs, PPOs, and Medicare. John Muir Health has partnered with several major health insurance providers, including Anthem Blue Cross and Cigna.

To determine if a physician is in-network with Anthem Blue Cross, patients can call the Member Service line, which is located on the back of their health insurance ID card, or visit Anthem's website. Anthem Blue Cross is one of the largest health benefits companies in the United States, serving more than 42 million members across all 50 states.

Cigna is another major health insurance company that John Muir Health has partnered with. To verify if a physician is in-network with Cigna, patients can call Cigna's Customer Service at 1-800-997-1654 or visit their website. Cigna serves millions of customers across the globe and offers a range of health insurance plans and related products to meet diverse needs.

In addition to Anthem Blue Cross and Cigna, John Muir Health also accepts other major health plans, such as Aetna, Blue Shield of California, Health Net, and United Healthcare. It is important to note that John Muir Health is not a contracted provider with any State Medicaid program. However, they do accept the fee schedule as payment for individuals enrolled in the Medi-Cal program who receive outpatient emergency services in the emergency department at one of their hospitals.

Frequently asked questions