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Know What to Ask to Ensure Your Access to Hoag

Asking the right questions during Open Enrollment can help you avoid unexpected surprises. Starting on January 1, 2023, access to elective services at Hoag facilities may be limited for commercial HMO and Medicare Advantage members assigned to a Greater Newport Physicians (GNP) primary care physician. Elective services subject to limitation include, but are not limited to, the following:

  • Physical Therapy
  • Maternity/Labor and Delivery*
  • Diagnostic Testing
  • Radiology/MRI/CT, PET scans
  • Cardiac Rehab
  • Mammography
  • Wound Healing Center
  • Radiation Therapy
  • Hoag Urgent Care
  • Elective inpatient and outpatient services at Hoag Hospital Irvine and Hoag Hospital Newport Beach*

* It is important to note that this change will not restrict or affect your access to emergency medical treatment at any Hoag hospital and you may also be entitled to receive continuity of care services for a limited  period of time for certain elective inpatient and outpatient services, including maternity care, as determined by your medical group or health plan.

Please contact Hoag Customer Service at 949-520-1423 or your health plan with questions.

It’s important to note that this change in access does not affect patients who have a PPO plan.

Access to All of Hoag—It’s as Easy as 1 • 2 • 3
For HMO and Medicare Advantage plan participants who want access to all Hoag services:

  1. Call the customer service number on your current insurance card, and request to change the Primary Care Physician and medical group.
  2. Provide the name of a Hoag Medical Group (HMG) or Hoag Physician Partners (HPP) Primary Care Physician.
  3. Once you receive your new insurance card, call the physician’s office to request an appointment. The change will typically take effect within 30-45 days of the request.

Selecting a health plan and Primary Care Physician can be confusing, and yet it is one of the most important decisions we make for ourselves and our families. At Hoag, we respect a patient’s right to make fully informed health care decisions, which is why we are here to answer any questions you may have as you make your selections.

Even if you were able to access Hoag through your Primary Care Physician in the past, be sure to check to ensure your continued access to all of Hoag, or call 949-520-1423.