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UHC Network Status

March 14, 2025

United Healthcare and Balboa network status

Dear Balboa Patient
Balboa Nephrology Medical Group takes immense pride in providing value-based care to our patients. Unfortunately, Balboa and United Healthcare have been unable to reach agreeable contract terms. Balboa continues to actively seek an agreeable contract, which allows Balboa to properly care for our patients. Unless an agreement is reached, as of June 1, 2025, Balboa Nephrology Medical Group will no longer be in-network with United Healthcare with all types of plans which are direct through United Healthcare.

If an agreement is not reached, it’s important to know the following to plan and consider your options:

  1. Understand additional costs if Balboa is no longer in-network with United Healthcare: Being out-of-network means that you may have higher out-of-pocket costs for care provided by your Balboa providers. Certain plans may not have out-of-network coverage. Please contact United Healthcare by calling the number on your insurance card to understand your out-of-network coverage and costs should Balboa become out of network.
  2. Consider changing plans to keep your Balboa and other healthcare providers: Balboa accepts many health insurance plans; a full listing is available on our website https://balboacare.com/patient-faqs/#insurance. The second page of this notice contains major Medicare Advantage plans Balboa accepts and those plans that are tailored to individuals with end stage renal disease (ERSD). Before changing insurance plans, please ensure Balboa Nephrology Medical Group (tax ID 952848091) is considered in-network.If you are covered under a United Healthcare Medicare Advantage plan below are two resources who can help you find a plan to keep your Balboa and other healthcare providers:
  3. See if you qualify for Continuity of Care with United Healthcare: You may qualify for Continuity of Care, which may allow you to continue care with your Balboa provider as in-network, for a specific period as determined by United Healthcare. Please reach out to your Balboa providers office to complete the following form if applicable: https://www.uhc.com/content/dam/uhcdotcom/en/memberresources/forms/CA-FI-TOC-COC-Form-English-WEB.pdf

We are hopeful that an agreement can be reached. We will continue to provide updates to you. The latest update will also be available on our website: www.balboacare.com

Please feel free to reach out to your providers office or our administrative office with any questions or concerns you may have. If you change your insurance, please call our office at 8(858)810-8000 to update your account. We want to ensure you have the information you need to access the care you deserve.

Sincerely,
Balboa Nephrology Medical Group

Below are major Medicare Advantage coverages accepted by Balboa. Those with an * offer plans that are tailored to individuals with end stage renal disease (ESRD).

  • Aetna
  • Align Kidney Care*
  • Alignment Health Plan*
  • Anthem Blue Cross*
  • Blue Shield of California*
  • Champion Health Plan*
  • Central Health Plan*
  • Community Health Group*
  • Health Net Wellcare*
  • Humana
  • Molina Healthcare*
  • Scan*
  • Sharp Health Plan
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