How a Health Plan Works

 

Our Network DiagramSan Francisco Health Plan is a managed care plan that provides medical, dental and vision insurance through its programs. The benefits and eligibility requirements for our programs are different depending on which program you or your family qualify for.

In managed care, your doctor (sometimes called a Primary Care Provider or PCP), clinic, hospital, and specialist work together to care for you and your family.

Your doctor provides basic health care needs as part of a medical group. A medical group is made up of specialists and other providers of health care services. A hospital is also connected with the medical group.

Your doctor and medical group direct the care for all of your medical needs. This includes authorizations to see specialists or to get medical services such as lab tests, x-rays and hospital care.