Insurance
We Accept:
PPO Plans Only
Anthem Blue Cross PPO
Aetna PPO
Blue Shield of California PPO
Cigna PPO
Cigna + Oscar PPO
Understanding Your Healthcare Costs
We want you to feel confident about how medical costs work, whether you have insurance or not. Here are some simple explanations of the most common terms you’ll hear:
1. Co-Pays
A co-pay is set amount you pay for a specific service, like a doctor’s visit or a prescription. For example, your co-pay might be $20 for a regular office visit. You pay this every time you receive that service, regardless of your deductible.
2. Deductibles
A deductible is the amount you pay out-of-pocket for covered services before your insurance starts helping with costs. For example, if your deductible is $2,000, you’ll pay 100% of your medical bills until you’ve spent $2,000. After that, your insurance begins to share the costs.
3. Co-insurance
Once you’ve met your deductible, co-insurance is the percentage of the bill you’re still responsible for. For example, if your insurance covers 80%, your co-insurance is 20%. So, for a $100 bill, you’d pay $20, and your insurance would pay $80.
4. Out-of-Pocket Maximum
This is the most you’ll have to pay in a year for covered medical expenses, including your deductible, co-pays, and co-insurance. Once you reach this limit, your insurance covers 100% of covered costs for the rest of the year.
Example: Putting it All Together
$1,000 Deductible
20% Co-insurance
$3,000 Out-of-Pocket Maximum
If you go to the doctor and the bill is $100, you pay the full amount until you’ve reached your $1,000 deductible. After that, for a $200 bill, you only pay 20% ($40) while insurance covers the remaining $160. Once your total out-of-pocket spending for the year hits $3,000, your insurance will pay 100% of all covered costs for the rest of the year.
Out of Network Plans
If we do not currently accept your insurance, you may still save money at our office if you have a high-deductible health plan, since you can continue using your insurance for lab work, imaging, or prescriptions. All of our services can also be paid for with Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs).
If Dr. Sarieh is considered “out-of-network,” you can still be seen at our clinic with a PPO plan. We will provide you with a detailed superbill to submit to your insurance company, and depending on your plan, you may receive partial reimbursement or have the visit applied toward your deductible (or both). Our team will assist you with this process.
In many cases, it may also be more cost-effective to schedule a few direct, cash-based visits with Dr. Sarieh rather than going to the ER or urgent care—especially if you have a higher PPO deductible or co-pay structure.
If Uninsured
Regular visits with your doctor are one of the best ways to prevent future complications, especially if you are living with chronic conditions. At Dr. Sarieh’s clinic, we keep our rates affordable so that even without full health insurance, a high-quality office visit remains within reach.
If you’re uninsured and require hospitalization:
Hospital bills can be overwhelming without coverage. To avoid catastrophic costs, it’s recommended to carry at least an emergency or minimum coverage plan, which you can find through the health insurance exchange. Trusted resources like Health for California insurance brokers can help you select a plan that fits your needs.