Health Insurance FAQs

When you’re not feeling well, the last thing you need is to stress about how you’re going to pay your bills. Below are the most frequently asked questions (FAQs) we receive about health insurance at Restoration Healthcare. If your question is not answered below, please email our Billing Department for more information using [email protected]

Q: Is my visit and the treatment I receive at Restoration Healthcare fully covered by my health insurance?

A1: The cost of your medical services is billed to your insurance company. Your insurance company determines what portion of the costs you are responsible for, and we will only send you a bill for what the insurance company determines is your responsibility for the treatment in question.

A2: We are in-network with most PPOs (Preferred Provider Organizations) and Medicare (please see below for a complete list as of Jan. 5, 2022). We bill according to the insurance contract that you purchased. Depending on your chosen plan, you may have a responsibility for deductibles, co-insurance, and/or copays. If you’d like, we can schedule time for a financial consult in order to go over those prices in more detail (email [email protected] with your preferred dates and times for a financial consult appointment and we will be in touch).

A3: Don’t panic just yet! When we’re working with patients to turn around chronic illness, it takes time. Depending on your plan and what part of the calendar year it is, you may need to evaluate if you want to go all in and meet your deductible sooner rather than later on, when the insurance should begin contributing as well.

A4: Due to this industry, we cannot pin down your exact financial responsibility. However, we are on the same side of the table, and we will always work with you.

Q: Why are Restoration Healthcare’s cash prices and insurance prices different?

A. In order to stay compliant with health care regulations, a cash price is calculated by analyzing our contract fee schedules with all the insurance companies.

Q: What health insurance plans does Restoration Healthcare accept?

A. As of January 1, 2022, Restoration Healthcare is considered in-network with the following health insurance plans:

  • Blue Shield of California PPO
  • Anthem Blue Cross PPO
  • United Healthcare (UHC)
  • Cigna PPO
  • Medicare PPO

As of January 1, 2022, Restoration Healthcare is considered in-network with the following health insurance plan, but treatment delivered by IV — with the exception of chelation — is not included:

  • Aetna

As of January 1, 2022, Restoration Healthcare is considered out of network with the following health insurance plan, but treatment delivered by IV is not included:

  • HealthNet

Please contact the customer service department (found on the on the back of your health insurance member identification card) to confirm if you have in-network access to Restoration Healthcare, as well as your benefit level, for care provided by Restoration Healthcare.

Q: Does Restoration Healthcare accept patients who are covered by Medi-Cal, Cal-Optima, or IHP Medi-Cal patients

A. Medi-Cal offers free or low-cost health coverage for California residents who meet certain eligibility requirements. Restoration Healthcare is not among the approximately 130,000 doctors and other healthcare providers who participate in the Medi-Cal, Cal-Optima, or IHP Medi-Cal programs.

Q: If I am covered by Medi-Cal, Cal-Optima, or IHP Medi-Cal, can I pay cash for treatment at Restoration Healthcare?

A. Restoration Healthcare cannot accept Medi-Cal, Cal-Optima, or IHP Medi-Cal cash payments from patients covered by Medi-Cal, Cal-Optima, or IHP Medi-Cal.

Q: What if I don’t have health insurance?

A. If you don’t have health insurance (or choose not to use the health insurance you do have), you can pay for your care at Restoration Healthcare with cash or credit card.