sutures newsletter


P and T Approvals, FDA Warnings

Pharmacy Focus

See highlights of the Oct. 7 meeting of the Pharmacy and Therapeutics Committee. Also, the U.S. Food and Drug Administration has issued warnings about lenalidomide, duloxetine hydrochloride, alglucosidase alfa and methoxy polyethylene glycol-epoetin beta.

Mark Your Calendar

Grand Rounds

Click here to view a schedule of all upcoming grand rounds.

Educational Schedule

Click the PDF link below to see the Department of Surgery's educational schedule.

Educational Schedule - December 2014 (PDF)

Surgery Scheduling

Click the "read more" for hours and contact information for surgery scheduling.

Share Your News

Know an interesting colleague we should profile? A story we should tell? Submit your ideas, meetings and events for consideration.

Click here to submit your news to Sutures

Insurance Update for Patients Who Want Cedars-Sinai Health Coverage (2015 Plan Year)

From Thomas M. Priselac, President and CEO 

Open enrollment for individual and family health insurance runs through Feb. 15, 2015, and many of you may get questions from patients who want to ensure that their plan continues to cover care from Cedars-Sinai. I'd like to share the following information to help you address such questions and let you know about the additional resources Cedars-Sinai has developed to help our patients navigate the changing insurance marketplace.

Please note that this open enrollment only affects people who purchase their own insurance policies for themselves and their families; it does not affect those who receive health insurance through their employer, such as Cedars-Sinai employees.

The first thing you should know is that the insurance options that include coverage for Cedars-Sinai have changed from the 2014 plan year. This applies to plans available both through the Covered California health benefit exchange and those purchased directly from an insurance company or broker.

The following plans provide coverage for care from Cedars-Sinai:

Through the Covered California health benefit exchange:

  • Anthem Blue Cross Exclusive Provider Organization (EPO) plans (all metal levels — e.g., Platinum, Gold, Silver, Bronze)

Through an insurance broker or insurance company directly (off the exchange):

  • Anthem Blue Cross
    • Anthem Blue Cross EPO plans (all metal levels — e.g., Platinum, Gold, Silver, Bronze)
    • Cedars-Sinai Medical Center is a Tier 1 facility in EPO plans.
    • Patients can keep coverage under a grandfathered Anthem Blue Cross plan that offers their full network of providers as long as they continue to pay premiums under the plan.
  • Assurant Health
    • Assurant Health offers a full range of Preferred Provider Organization (PPO) network plans — using the Aetna PPO physician and hospital network.

At this time, it is unclear whether Cedars-Sinai will be included as a participating provider in Health Net's PPO network. Patients who want coverage for Cedars-Sinai and are interested in making a change for the 2015 plan year should consider switching to an Anthem Blue Cross EPO plan or Assurant Health PPO plan.

Patients also can keep coverage for Cedars-Sinai if they have a grandfathered Blue Shield plan that offers a full network of providers and they continue to pay premiums under the plan. Note that Cedars-Sinai is not a participating hospital in the Blue Shield PPO plans offered through Covered California, directly through Blue Shield, or through an insurance broker.

Those currently enrolled in an individual or family insurance product that will continue to be offered in 2015 were automatically re-enrolled in that product on Dec. 15; however, they will be able to switch plans until Feb. 15.

We recognize that there are many people who want to come to Cedars-Sinai but may be concerned about out-of-pocket costs such as deductibles and co-pays for hospital services. To make things easier for our patients, we offer a variety of financial assistance programs that can help people with some of these costs. These programs are available to a wide range of incomes, and more information is available online or by calling Patient Financial Services at 323-866-8600.

For your reference, linked below are a letter and fact sheet that we recently sent to our patients who likely have individual and family health insurance. For the most up-to-date information and guidance, please access the following resources:

Individual Insurance Patient Letter - December 2014 (PDF)

Plan-By-Plan Fact Sheet (PDF)