Which Insurance Plans Does UCSF Health Accept?

UCSF Health accepts a broad list of insurance plans, including Medicare, Medi-Cal, several Covered California exchange plans, and contracts with most major commercial carriers such as Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Kaiser Permanente, and UnitedHealthcare.¹ The important caveat is that appearing on UCSF’s contract list is not a guarantee of full access. The specific product you carry under a given carrier, HMO versus PPO versus EPO, and whether your plan requires a referral or pre-authorization, determines what UCSF can actually bill as in-network care.

Commercial Carriers With UCSF Contracts

The major private insurers with in-network agreements at UCSF, and the plan types each contract covers:¹

Aetna commercial: HMO, POS, PPO, and EPO, though UCSF is in only some Aetna EPO plans.
Anthem Blue Cross: CaliforniaCare HMO, Blue Connection HMO and EPO, Prudent Buyer PPO/EPO, and Plus POS.
Blue Shield of California: Access+ HMO, TRIO HMO, Preferred PPO, Preferred Plus PPO, SELECT PPO, Narrow Network EPO, and HMO Plus POS.
Cigna: HMO, PPO, POS, and Medicare Advantage. UCSF is not in-network for Cigna’s Pathwell product line.
Health Net: HMO (including Blue & Gold and Canopy Health options), PPO, ELECT POS, and Smart Care/Canopy Health HMO.
Kaiser Permanente: HMO, ASO PPO, Medi-Cal HMO, and Medicare Advantage HMO.
UnitedHealthcare: multiple HMO and PPO products.

Smaller regional plans also contract with UCSF, including Chinese Community Health Plan, Aspire Health Plan, and ASMED Health Partnership. Workers’ compensation coverage is accepted through carriers such as First Health/Coventry and CorVel Corp. Transplant-specific networks like Interlink and Lifesource have agreements as well.¹

How Your Plan Type Affects Access

Being on the contract list is only half the story. Your plan type decides how easily you can actually see a UCSF provider. PPO plans let you book specialists without a referral, though UCSF may sit in a higher cost-sharing tier than community hospitals. HMO and EPO plans limit coverage to in-network providers except in emergencies, and HMO plans generally require your primary care doctor to issue a referral first.² POS plans sit in between: a referral is required, but you can go out-of-network at a higher cost.

Tiered networks matter too. Some commercial plans place UCSF in a more expensive tier, so your coinsurance might be 30% at UCSF against 20% at a different in-network hospital. The plan’s Summary of Benefits and Coverage, which federal rules require insurers to provide, lays out the deductible, copays, coinsurance, and out-of-pocket maximum for in-network and out-of-network care in a single comparable format.³

Medicare and Medicare Advantage

UCSF participates in Medicare and bills the program directly.⁴ Part A covers inpatient hospital stays, skilled nursing care, and hospice; Part B covers outpatient services like doctor visits, lab work, and preventive screenings.⁵ Original Medicare leaves you responsible for deductibles, coinsurance, and some copayments, which add up quickly at a complex academic medical center.

Medicare Advantage (Part C) plans bundle coverage through a private insurer and use their own networks. UCSF contracts with several Advantage carriers, including Blue Shield 65+, Cigna, Chinese Community Health Plan, Health Plan of San Mateo, and Kaiser Permanente.¹ Because each Advantage plan runs its own network, verify UCSF’s status under your specific plan before scheduling.

Dual-eligible patients enrolled in both Medicare and Medi-Cal under the Qualified Medicare Beneficiary program cannot be billed by Medicare providers for deductibles, coinsurance, or copayments on covered services.⁶

Medi-Cal Plans Accepted at UCSF

UCSF accepts fee-for-service Medi-Cal and a specific set of Medi-Cal managed care plans:¹

San Francisco Health Plan (standard Medi-Cal HMO, UCSF Primary Care, and SF Cares for Kids)
Kaiser Permanente Medi-Cal HMO
Alameda Alliance for Health
Central California Alliance for Health
Health Plan of San Joaquin
Health Plan of San Mateo Medi-Cal (pediatrics only)
Partnership Health Plan

Most of these plans require your managed care plan to authorize a referral before UCSF can treat you; without the authorization, the plan may refuse to pay. Anthem Blue Cross Medi-Cal Managed Care is a narrower case. UCSF holds a contract with Anthem Medi-Cal only for tertiary (highly specialized) care, not routine services, and Anthem must pre-authorize treatment.¹ UCSF does not contract with other states’ Medicaid programs, so out-of-state Medicaid coverage will generally not work at UCSF.

Covered California Exchange Plans

If you bought your plan through Covered California, access to UCSF varies sharply by carrier. Blue Shield Covered California HMO and PPO plans include UCSF, as does Blue Shield TRIO Covered California HMO. Health Net’s Covered California Small Business (SHOP) PPO also contracts with UCSF.¹

Anthem Blue Cross Covered California plans are the exception to watch. UCSF is not a general in-network provider under those plans. Anthem contracts with UCSF only for tertiary care that Anthem has pre-authorized, so routine office visits, standard imaging, and similar services will not be covered as in-network under Anthem exchange plans.¹ Western Health Advantage Covered California HMO has hospital-only coverage at UCSF and requires a referral. For broad access through an exchange plan, Blue Shield products offer the most direct route.

Why the Contract List Isn’t a Guarantee

UCSF’s own insurance page warns that even when your plan appears on their list, that does not mean every UCSF service is available to you.¹ Some plans limit access to certain departments, cover only specialized referrals, or place UCSF in a higher cost tier. The hospital-wide list also does not apply to every UCSF facility: UCSF Health Stanyan Hospital, Hyde Hospital, and the inpatient and partial hospitalization programs at Langley Porter Psychiatric Hospital each maintain separate insurance arrangements.

Before scheduling, do three things:

Call your insurer and ask whether UCSF Medical Center is in-network for your specific plan and for the service you need. Online directories lag behind contract changes.
Contact UCSF Patient Financial Services at (866) 433-4035 or (415) 353-3333 to confirm network status and any referral or pre-authorization requirements.⁴
Request your Summary of Benefits and Coverage from your insurer. Comparing the in-network and out-of-network columns tells you how much more you would pay if UCSF turns out to be out-of-network for your plan.³

If you want a personalized out-of-pocket estimate before care, UCSF’s Patient Estimate Program is reachable at (844) 678-6831.⁷

If a UCSF Provider Turns Out to Be Out-of-Network

Even when UCSF itself is in-network, individual providers inside the hospital (an anesthesiologist or pathologist, for example) sometimes are not. The federal No Surprises Act, in effect since January 2022, limits what you can be billed in two situations:⁸

Emergency services. If you receive emergency care at UCSF from an out-of-network provider, the provider cannot bill you more than your plan’s in-network cost-sharing, and your payments count toward your in-network deductible and out-of-pocket maximum.⁹
Non-emergency care at an in-network facility. An out-of-network provider working inside an in-network UCSF facility generally cannot balance-bill you unless they gave you written notice and you signed a consent form in advance.

These protections do not cover ground ambulance services, and they do not apply when you voluntarily choose non-emergency care at a facility you know is out-of-network.⁸

If You’re Uninsured or Can’t Afford Your Share

UCSF offers financial assistance regardless of insurance status. Uninsured patients with family income at or below 400% of the federal poverty level qualify for a full charity care write-off: 100% of the bill is forgiven. For a single person in 2026, that threshold is $63,840; for a family of four, it is $132,000.¹⁰¹¹

Insured patients facing high residual costs may qualify for High Medical Cost Charity Care. The program applies when family income is at or below 400% of the federal poverty level, or when out-of-pocket medical expenses over the past 12 months exceeded 10% of family income. UCSF then writes off 100% of the remaining patient responsibility after insurance pays.

Applications are available through UCSF’s MyChart portal or by calling Patient Financial Services at (866) 433-4035. You will need your most recent tax return or recent pay stubs for income verification, and you must submit the application within 240 days of your first bill. A denial can be appealed within 30 days.

1
UCSF Health. Health Insurance
2
HealthCare.gov. Health Insurance Plan and Network Types
3
eCFR. 45 CFR 147.200 – Summary of Benefits and Coverage and Uniform Glossary
4
UCSF Health. Billing and Insurance
5
Medicare.gov. Parts of Medicare
6
Centers for Medicare & Medicaid Services. Qualified Medicare Beneficiary Program
7
UCSF Health. Pricing Transparency
8
Centers for Medicare & Medicaid Services. The No Surprises Act at a Glance
9
Office of the Law Revision Counsel. 42 U.S. Code 300gg-111 – Preventing Surprise Medical Bills
10
UCSF Health. Help Paying Your Bill
11
HHS ASPE. 2026 Poverty Guidelines