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UC DAVIS DROPS WESTERN HEALTH ADVANTAGE INSURANCE PLAN!

Updated: Feb 4, 2018

What are your options for Sacramento health insurance with UC Davis dropping Western Health Advantage Insurance Plans.




UC DAVIS DROPS WESTERN HEALTH ADVANTAGE INSURANCE PLAN!

You’ve gotten some bad news lately if you are a Sacramento area business with Western Health Advantage HMO (health maintenance organization) insurance you have recently and utilize UC Davis medical center. Effective 1/1/18 UC Davis will no longer be a contracted provider for Western Health Advantage insurance plans.

That means, if you are enrolled in Western Health Advantage and utilize doctors, hospitals, or medical groups with UC Davis you will have to change your doctors.


What is happening and when?

Western Health Advantage, a low cost Sacramento area HMO plan is unable to renew its provider contract starting in 2018 with UC Davis Medical System, which is one of the more expensive medical providers in the greater Sacramento, Placer, and El Dorado areas.

Is there a chance this contract renews?


Yes, with insurance carriers sometimes part of the negotiation process they let the provider contract cancel with notification letters getting sent to members. This puts more pressure on both sides as members complain or seek other companies to deal with.


Why did this happen?

UC Davis Health System, one of the Sacramento area’s premier provider of medical services, terminated their Western Health Advantage agreement in the re-negotiation of medical cost services contract. They are at odds with the low cost delivery model of Western Health Advantage. Western Health Advantage would need to raise insurance premiums far higher vs. the current levels to keep UC Davis at the reimbursement amounts for medical services required.


What doctors will I have access to?

Western Health Advantage will still maintain a robust network of providers in the Sacramento area, as well as some expansion into the Bay Area in Northern California with some exciting new announcements.

In the Sacramento area, if you are currently enrolled with UC Davis for primary care you have until December 15th to choose a new primary care doctor and medical group with Hill Physicians or Mercy Medical Group or one will be automatically assigned to you.

WHA will provide access to medical care in 13 counties in Northern California through 25 hospitals and 5800 doctors.


You can search for a WHA doctor here.

There is more information on choosing a primary care doctor in the Changing Your PCP flyer.

The easiest way to change your primary care physician for members is to over the phone by calling WHA at 916.246.7494.


WHA Exciting New Healthcare Provider Announcement

Western Health Advantage recently signed an agreement to launch medical insurance with Canopy Health, founded by John Muir Health and UCSF. Canopy Health will expand WHA insurance access into new Bay Area markets previously not available to the Sacramento based insurer starting in 2018.


Western Health Advantage Small Business Benefits

An overview of WHA Small Business Plan Benefits can be found online here. The same plans are available in Sacramento and all Northern California coverage counties seen on the map below.


LOSING YOUR UC DAVIS DOCTOR?

Don’t panic!


Here’s some simple ways you may be able to keep your UC Davis doctor

-Does your company offer another plan?

If your company offers another health plan, such as an Anthem Blue Cross or Blue Shield of CA you probably have UC Davis access by choosing one of these options


-CONTINUITY OF CARE

If you are currently under treatment for a medical issue, such as cancer, previously approved surgery, pregnancy, etc..you may qualify for Continuity of Care to receive treatment from UC Davis for that condition. In this case contact Western Health Adv. at 1.888.563.2250 for information. Western Health Advantage has also provided personal service if you are in this situation and need some help with the transition. The website resources and forms for download can be found at https://www.westernhealth.com/mywha/


WHA SERVICE COVERAGE AREA


COUNTY AVAILABILITY

  • EL DORADO: Coverage available in only certain zip codes: (95613, 95614, 95619, 95623, 95633, 95634, 95635, 95636, 95651, 95656, 95664, 95667, 95672, 95682, 95684, 95709, 95726, 95762)

  • PLACER : Coverage in only certain zip codes: 95602, 95603, 95604, 95626, 95631, 95648, 95650, 95658, 95661, 95663, 95668, 95677, 95678, 95681, 95703, 95713, 95722, 95736, 95746, 95747, 95765

  • SACRAMENTO: Every Zip Code included in the County covered

Covered California Small Business SHOP Update!


Does Obamacare do anything to help small businesses?

What looked like a great idea on paper, the Small Business Tax Credit, was spoiled by too few companies able to actually save money. It’s a shame, because it was one of the few areas of the ACA bill which actually helped small businesses.

So, in the end, Western Health Advantage, headquarters based locally here in Sacramento, canceled CoveredCA 2018 availability for Small Business and Individual/Family plans. Beginning at your employer plan renewal month in 2018, Western Health Advantage is ending availability through Covered California Small Business (formerly ‘SHOP’). This company requested ‘de-certification’ is due to lukewarm business interest in the program largely because of the very strict qualification and minimal tax savings guidelines allowed by Obamacare laws.

The Small Business tax credit is still available with other top participating insurance carriers through Covered California Small Business department, such as:

  • Kaiser Permanente

  • Blue Shield of California

  • Health Net of California

  • Sharp Health Plan (San Diego County)

  • Chinese Community Health plan

  • Information on the Small Business Tax Credit can be found here.

  • What other services does WHA provide Sacramento area members?

  • Western Health Advantage

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