Medical Coverage, Health Insurance and Self-Pay
Scripps Health accepts the following forms of payment for medical services:
- County Medical Services
- HMO Insurance
- Medi-Cal Coverage
- Medicare Coverage
- PPO/Commercial Insurance Coverage
County Medical Services
If your health care is covered under County Medical Services (CMS), you must bring your current month’s proof of eligibility paperwork with you when you check in, and scheduled procedures require authorization. Please check with your physician to ensure services have been authorized.
If you’re seeking emergency room treatment, you will also be required to complete an additional form.
If you are enrolled in an HMO insurance plan, please note that an authorization is required for most services and that any patient portion (co-pay) of the bill will be due at the time of service.
To ensure health care services are authorized, you should contact your primary care physician (PCP) prior to receiving any treatment, including emergency room visits. If treatment is determined not to be medically necessary and/or authorization is not obtained prior to treatment, you may be completely responsible for the bill.
If you have Medi-Cal, non-HMO coverage, please present your Medi-Cal card at registration. Eligibility will be verified at the time of your service. Some restrictions may apply to your benefits, for example, with pregnancy-related and emergency-related benefits only.
If you are seeking treatment for non-covered services or you have a “share of cost,” you will be responsible for payment.
If you were eligible for Medicare benefits at the time of your care, we will send your bill to your government insurance carrier. Medicare coverage has two basic parts:
- Part A (hospital coverage) pays for the services provided when you were a patient in the hospital.
- Part B (medical coverage) pays for health care services you received as an outpatient, and for physician fees.
Medicare Part A and B deductibles are set annually by the U.S. government. If you do not have supplemental insurance, the deductibles are your responsibility, as are certain charges not covered by Medicare, such as private rooms or take-home drugs.
PPO/Commercial Insurance Coverage
If you are enrolled in a PPO or commercial insurance plan, your coverage will vary depending on the plan. Upon receiving benefit information from your insurance carrier, we will estimate the portion to be paid by your insurance and the estimated balance due from you. Please be prepared to make a deposit on the estimate.
Scripps has contracts with most PPOs. Contact your insurance carrier to verify they have a contract with Scripps. If you belong to an insurance plan that does not have a contract with us, your benefits may be reduced or denied.
If you are planning to pay for your health services yourself, payment or payments will be requested during your visit. For your convenience, Scripps accepts the following payment methods: cash, MasterCard, Visa, American Express, Discover, debit cards, personal checks, money orders and cashier’s checks.