SUN HEALTH MEDICAL CLINIC

HEALTH INSURANCE

PLAN TYPES

PREFERRED PROVIDER ORGANIZATION (PPO) PLANS

With PPO plans, no Primary Care Provider (PCP) is mandated, however it is important to have a PCP for optimal quality care.  With PPO plans you can self refer and if you do, inform us so we can coordinate care and exchange information with the specialist.  


We are closed to New patients for some plans so please see above for details.  For Aviation or Immigration medical examinations, if we are contracted with your insurance then we will still bill them on your behalf.  If you are already established with us, we are loyal and will continue you care no matter what plan you choose.

HEALTH MAINTENANCE ORGANIZATION (HMO) PLANS

Managed Care

Managed Care health plans such as Health Maintenance Organizations (HMOs) require that you designate a Primary Care Provider (PCP) in an affiliated medical group.  PCP = Dr. Sunita Shailam in Mercy Physicians Medical Group.

* CLOSED TO NEW PATIENTS

We have been closed to new managed care patients since 2020.  If you have an HMO health plan and were inadvertently assigned to us after 2020 and have never been here, we can still see you, however you are encouraged to change your provider your Primary Care Provider (PCP) to your previous provider in order to preserve continuity of care.  To change your PCP, you may do so by calling your insurance plan or on the insurance website.


OPEN TO ESTABLISHED PATIENTS

If you are our established patient and have changed insurance with automatic assignment to another doctor, you may switch back to us.  As soon as you get your new insurance, call them because it takes time to for a PCP change to be effective.  If you call before the 15th of the month it will be effective the following month and if you call after the 15th of the month you have to wait until the 1st in 2 months.  For example, if you call 14 August it will be effective 1 September and if you call 15 August it will be effective 1 October.  Plan in advance because we do not accept same month transfers.

OTHER (including Kaiser) INSURANCE or NO INSURANCE

Accepting patients for Aviation and Immigration.  Not accepting out-of-network new patients for primary care; you may consult your insurance provider directory or Family Health Centers of San Diego.

FEES

Primary Care

Aviation

Immigration

Health Insurance Agent