Insurance Information

Below are Insurance Companies and Health Plans that Kaweah Health maintains hospital facility contract with. All of our licensed facilities can service members having any of these insurance plans; however, patient liability and patient benefits are determined by how the claims are billed and what is negotiated in our contracts.

Commercial insurance contracts are subject to change. If your insurance is not listed, please contact our office at (559) 624-2555 for assistance.

Letter of Agreement (LOA) - if your patients insurance is not contracted with Kaweah Health Medical Center, a Letter Of Agreement (LOA) or single case agreement will need to be requested at the time of authorization. If the insurance company and our insurance team approve the letter of agreement then we can proceed with treating the patient here.

Insurances we accept:

• Commercial
  • Aetna (HMO & PPO)
  • Anthem Blue Cross of California (HMO & PPO)
  • Beach Street
  • Blue Shield of California (HMO & PPO)
  • Cigna Health Care of California (HMO &PPO)
  • Foundation for Medical Care for Tulare & Kings Counties
  • Great West Healthcare (OA & PPO)
  • Health Net (HMO & PPO)
  • Humana (HMO & PPO)
  • Health Smart (PPO)
  • Key Medical Group
  • Multiplan (PPO)
  • Networks By Design
  • State Fund
  • Tri-Care
  • United Healthcare (UHC) (HMO & PPO)
• Managed Care Medi-Cal (No IPA Affiliations)
  • Anthem Blue Cross Medi-Cal Managed Care
  • Health Net Medi-Cal Managed Care
• Independent Physician Associations (IPAs)
  • Dignity Health (Medi-Cal Only)
• Medicare Advantage (No IPA Affiliations*)
  • Anthem Blue Cross (No IPA Affiliation**)
  • Health Net Wellcare DSNP (Key Medical Gropup ONLY)
  • Humana (Key Medical Group ONLY)
• State/Federal Insurance Programs
  • Medi-Cal (Traditional - No Health Plan Affiliation)
  • Medi-Care (Traditional - No Health Plan Affiliation)

Explanation of billing and prior authorization

• We bill insurance under the medical side and not the pharmacy side.
• We cannot accept medication from outside pharmacies. There are specific exceptions to this rule, when we are working directly with the manufacture.
• For Medicare patients, we bill under part B and when there is a supplemental then the supplemental will pick up the 20% patient responsibility. We cannot bill under part D.
• Medicare patients do not require authorization since we bill under part B.
• Straight Medi-Cal may require authorization please contact Medi-Cal or our office to verify if authorization is needed.