Insurance Resource Center

Choosing an insurance plan that offers the best care for your family can often feel overwhelming. Valley Children's wants to help. In this section, you will find helpful resources and information on choosing a health plan that includes Valley Children's.

To talk with a Valley Children's insurance navigator:
(559) 353-7028
 

Important Health Plan Update

Effective August 15, 2023, Valley Children’s Hospital is no longer in network with Cigna.

For several months, Valley Children’s Hospital has been working to renew our insurance contract with Cigna. Unfortunately, we were unable to come to an agreement. As a result, effective August 15, 2023, Valley Children’s will not be able to provide contracted services for Cigna patients at the following locations:

  • Valley Children’s Hospital in Madera
  • Charlie Mitchell Children’s Center in Madera
  • Olivewood Specialty Care Center in Merced

Services at any of Valley Children’s primary care practices in Bakersfield, Clovis, Fresno and Merced; as well as specialty services provided at Eagle Oaks Specialty Care Center in Bakersfield, Pelandale Specialty Care Center in Modesto, Akers Specialty Care Center in Visalia and Spruce Specialty Care Center in Fresno, and Templeton Specialty Care Center in San Luis Obispo County can continue through October 9, 2023. After October 9, 2023, all Valley Children’s locations and providers will be out of network for Cigna patients.

During this time of transition, our patients remain our utmost priority. We take this responsibility seriously, as well as the need to avoid putting significant strain on patient families. We are working diligently with Cigna to ensure our patients receive full transition of care. In the meantime, we recommend that you:

  • Check your coverage. If you have been receiving care from a Valley Children’s Hospital healthcare provider, you may have a right to keep your provider for a designated time period through Continuity of Care. You may contact your plan for answers to questions about your insurance coverage and your access to medical providers. Please contact Cigna at the phone number on the back of your insurance card.
  • Contact your PCP or Cigna for in-network referrals. Should the patient not qualify for Continuity of Care, please contact your Primary Care Physician or Cigna to request a referral within the Cigna network.
  • In case of an emergency, visit the emergency department. Patients will always have access to emergency services at Valley Children’s Hospital, regardless of insurance coverage. If your child has a medical emergency, take them to the nearest emergency department or call 911.

Thank you for your support during this time of transition. If you have any questions, please call us Monday – Friday between 8 a.m. and 5 p.m. at 559-353-7028 or email us at ContactUs@valleychildrens.org.

 


Insurance FAQs

Below are some of the most common questions about insurance. If you have a question you don't see listed here, or need additional explanation, please call a Valley Children's insurance navigator at (559) 353-7028.

Click here to view which insurance plans in your area cover Valley Children's services.

  • Verify that your pediatrician is in the Valley Children’s provider network by reviewing the provider directory on the insurance company's website.
  • Verify that your pediatric specialist is in the Valley Children’s provider network by reviewing the provider directory on the insurance company's website.
  • Get it through your employer.
  • Buy it from a broker or insurance agent
  • Medi-Cal 
    • To learn if you are eligible, contact a Valley Children’s financial counselor at (559) 353-7009 to apply.
  • Buy it on the Health Insurance Exchange:

There is a requirement that all Americans have health insurance. The exchange is the health insurance marketplace where you can find, compare and buy health insurance plans.

The amount you owe (out-of-pocket cost) depends on the benefits available through your insurance plan. Your costs are determined by the services provided and may include your copay, coinsurance and the amounts of individual and family deductibles. For more information about your out-of-pocket costs, please call your insurance company to find out what is covered by your plan. If you would like an estimate for what your out-of-pocket costs will be for your visit, please call (559) 353-7009

Please call our financial counselors for help at (559) 353-7009. You may be eligible for financial assistance.  


Insurance Plans That Include Valley Children's Services

Valley Children’s Healthcare contracts with several health plans throughout the Valley to provide hospital and physician services. If you have questions about contracted insurance providers, please call us at (559) 353-7028 to speak with a Valley Children's insurance navigator. 

Insurance plan coverage may change depending on the county you live in. Select your county from the dropdown menu below to see which plans in your county contract with Valley Children's Healthcare to provide hospital and physician services