My wife and I are in our 50s and live in California. We’re about to lose our COBRA coverage from United Healthcare. I’m no longer working and don’t plan to go back.
My wife has had serious health issues, including cancer, and we’ve maxed out our plan every year for the past five years. Hopefully, things are improving, but we still need solid coverage just in case.
I checked Covered California, and the only options I see are Anthem and Blue Shield. We’ve been going to Stanford for her care—do any of these plans actually work well for that? Would love to hear from anyone with experience.
The key thing is checking which plans actually include Stanford in their network.
Both Anthem and Blue Shield are decent, but the details matter—especially with ongoing health concerns. If cost isn’t a major issue, a Platinum PPO plan might be the best option since it gives you more provider choices and lower out-of-pocket costs.
It might help to make a spreadsheet comparing total yearly costs for different plans, not just premiums but also deductibles and max out-of-pocket expenses.
@Marlow
From what I found, Stanford only takes Valley Health HMO and Blue Shield Trio HMO through Covered California. Neither includes our current primary care doctors, which is frustrating.
Quill said: @Marlow
From what I found, Stanford only takes Valley Health HMO and Blue Shield Trio HMO through Covered California. Neither includes our current primary care doctors, which is frustrating.
I’m not familiar with Stanford’s network specifically, but in Los Angeles, world-class hospitals like UCLA and Cedars-Sinai have similar HMO arrangements.
If your priority is staying at Stanford, you might have to switch to a provider within their accepted networks. Have you asked your current doctors if they recommend anyone within those networks?
Quill said: @Marlow
From what I found, Stanford only takes Valley Health HMO and Blue Shield Trio HMO through Covered California. Neither includes our current primary care doctors, which is frustrating.
You don’t both have to be on the same plan. You could choose a plan that keeps your current doctor, and your wife could pick a different plan that includes Stanford. It’s not ideal, but it might be a way to get the best coverage for both of you.
Quill said:
Valley Health is another option, but none of our doctors take it. I’ve never even heard of them before.
What did you end up doing? I’m in a similar situation. My spouse has multiple health issues and sees private practice doctors, one of whom told us that ‘no one takes Covered California plans’ and suggested getting private insurance until Medicare kicks in. I find that hard to believe. Wondering what your experience has been.
@Anthony
Not OP, but Stanford’s insurance options haven’t improved. Outside of employer-sponsored plans, the only marketplace options are Kaiser and Valley Med HMO for 2024 and 2025.
Kaiser didn’t work out for me because they don’t refer to Stanford for anything. If I don’t get an employer plan, I’ll probably try Valley Med HMO next.
If distance isn’t a problem, UCSF is an alternative. They accept some Covered California PPOs, though they’re pricey.