Healthcare Partners and AppleCare Medical Group Contract

The new contract is now in effect and extends into August of 2027. This means that patients with primary care physicians who are affiliated with either Healthcare Partners or AppleCare Medical Group (which are now part of Optum) can once again access all inpatient and outpatient services provided at MemorialCare hospitals, which include Long Beach Medical Center, Miller Children’s & Women’s Hospital Long Beach, Orange Coast Medical Center, and Saddleback Medical Center. Patients of Healthcare Partners and AppleCare can also access MemorialCare’s community-based ambulatory centers for outpatient surgery, imaging, physical therapy and dialysis services.

Monarch Healthcare Contracts

We are also pleased to report that we have agreed with Optum on amendments to our Monarch Healthcare agreements to extend them through December 31, 2027. This means that both commercial HMO and Medicare Advantage patients with primary care physicians who are part of Monarch Healthcare will continue to have network access to all of the same MemorialCare hospitals and community-based ambulatory centers for inpatient and outpatient services.

Regardless of when your employer offers open enrollment

You have the right to change your primary care physician at any time for any reason. Simply call your health insurance company. The change will go into effect on either the first day of the next month or the first day of the following month depending on when you request the change. We know you have many options in health systems, health plans, and medical groups. As you consider your options, and if you want to ensure access to MemorialCare, you may call your health plan.
More Options
Call (877) 696-3622

Medicare Advantage Enrollment

For retirees, having the right health plan gives you freedom that only good health can provide. It’s knowing your health is not just your priority, but also the priority of the doctors and providers you’ve chosen. Have you thought about whether your current coverage still meets your needs?

The Medicare Annual Election Period runs every year from October 15 through December 7

This is your opportunity to choose from among the best plans with little or no additional out-of-pocket expenses. Even if the Medicare Annual Election Period (open enrollment) has passed, you have the right to change your primary care physician at any time for any reason. Simply call your health insurance company. The change will go into effect on either the first day of the next month or the first day of the following month depending on when you request the change. As you consider your options, if you want to ensure access to MemorialCare, you may call your health plan.
See Options
Call (877) 696-3622

General Guidance on Health Plan and Physician Group Selection

Whether you are choosing an employer-sponsored plan, a Medicare plan, or a private plan “on or off” the Covered California Exchange, it is a good idea to first review your current plan to make informed comparisons with new options. Here are some questions to ask when you are reviewing your current plan:

  • What did and didn’t work this year?
  • Do I anticipate any major medical needs for next year, such as surgery, medical equipment, pregnancy, or others?
  • Do I foresee any new medications and what tier will they be on the plan formulary?
  • What were my out-of-pocket costs for this year, (include premiums, co-pays, deductibles, and payments for non-covered services)?

Once you have answered those questions, new plan options can be evaluated with these additional questions:

  • Do I want to keep my family physician and if I do, can I?
  • What is the trade-off between possible premium costs and out-of-pocket expenses such as co-pays, deductibles, or others?
  • Are the costs “up-front” or as I use the services?
  • Will this plan work better for me/us?

Choosing the Right Physician

An equally important part of the process is choosing a healthcare provider. Ultimately, the value of the health plan option you select is determined by the quality of the physician who delivers the care and administers the medical benefits.

“They all say they’re good doctors, so how do I know who the best is for me?”

As with health plans, you should research and ask questions about the physician you are considering. Getting recommendations from family and friends is a good place to start. For fact-based information, look to un-biased sources.

Independent, third-party organizations such as Integrated Healthcare Association (IHA), California Cooperative Healthcare Reporting Initiative (CCHRI) and the Office of the Patient Advocate (OPA) of California, among others, routinely survey patients and publish service and quality of care ratings on physicians and physician groups. You can visit these websites to investigate the scores and grades given to the physicians.

Look for More from Your Health Care Provider

Along with high ratings from independent sources, you can maximize your plan benefits by looking at what the health care provider has to offer in the way of convenience, services, and best practices. Look for a great full-service health care provider who provides:

Access to Care

  • Same-day appointment availability
  • Urgent care access at the same co-pay as an office visit and with no pre-authorization needed
  • Flexibility to be seen near work or home
  • 24-hour telephone access to a nurse advice line
  • Onsite lab and x-ray
  • Connectivity to award-winning hospitals
  • Fully credentialed specialty physician network

Up-to-Date Technology and Practices

  • Best practice, evidence-based medicine
  • An electronic medical record (EMR) system connecting patient, physician, urgent care, hospital, and other services
  • Online (email) communication with physicians and the office
  • Access to medical records and test results
  • Electronic transmission of prescriptions to pharmacies
  • Specialty nurses to assist and follow patient care whether in the hospital or at home

If you’re considering making a change and would like to learn more about access to MemorialCare, VISIT HERE. Even if you decide not to make a health plan or physician group change, going through this review process can bring you peace of mind by knowing you chose the right health plan and physician.