Torrance Memorial Medical Center has been your hospital for years—for
routine checkups, for care when you’re ill. But let’s say
you’ve just changed employers, you’re choosing your own health
insurance for the first time, or you’re joining Medicare or Covered
California. How can you be sure you’ll be able to keep your family
doctor and continue to receive care at Torrance Memorial?
First, the good news: there is no bad news. Torrance Memorial has agreements
with most major health insurance plans.
Now the other news. It’s still not bad news: you may have several
different health insurance plans from which to choose. That can be a positive,
but choosing the best plan for you can be a complicated process. There
are several factors to consider, but as far as ensuring you will be able
to receive care at Torrance Memorial, the difference between health insurance
plans lies in their provider networks.
Receiving care from a provider in your insurance plan’s network—that
is, an innetwork provider—generally is easier and costs less than
receiving care from an out-of-network provider. Different types of health
insurance coverage have different rules.
Exclusive Provider Organizations (EPOs): Generally limit coverage to care
from in-network providers, except in emergencies.
Health Maintenance Organizations (HMOs): Generally limit coverage to care
from providers who work for or contract with their organization, except
in emergencies. HMOs usually require their covered members to have a primary
care physician (PCP); you will need a referral from your PCP to see a
specialist. When you enroll in an HMO, the primary care physician you
choose will affect where you are referred for inpatient and outpatient
hospital services. Physicians with Torrance Memorial refer patients to
Torrance Memorial Medical Center.
Preferred Provider Organizations (PPOs): Allow you to receive care from
in-network and out-of-network providers, although you will pay more to
receive care from out-ofnetwork providers.
Point-of-Service Plans (POSs): Allow you to receive care from in-network
and out-of-network providers. You’ll choose a primary care physician
from your POS plan’s network. You’ll be able to visit any
provider without first receiving a referral, but you will pay more to
receive care from an out-of-network provider.
If you select a physician in one of the following groups, you can be assured
that you will have access to Torrance Memorial:
• Torrance Hospital IPA
• HealthCare Partners South Bay
• HealthCare Partners IPA, South Bay
When you’re choosing a health
insurance plan, there are a few questions you should ask the insurance
company and/or your chosen primary care physician to ensure you’ll
be able to receive care from Torrance Memorial physicians, specialists
> Does this plan include Torrance Memorial Medical Center physicians
> Are Torrance Memorial physicians and facilities in-network or out-ofnetwork
providers for this plan?
> If Torrance Memorial physicians and facilities are not part of this
plan’s network, will I still be able to receive care from them as
out-of-network providers? Will I need a referral first? How much will it cost?
> Will I be able to choose a Torrance Memorial physician as my primary
> If I select a particular Torrance Memorial physician as my primary
care physician, to which hospital will I be referred for inpatient and
> Is the Torrance Memorial physician I want to select as my primary
care physician currently accepting new patients?