Last reviewed September 21, 2026.
Your Doctors May Be in Different Cities
You might see your regular doctor in Santa Monica, visit a specialist in a neighboring city, and go to a hospital somewhere else. Before choosing a Medicare Advantage plan, check whether the specific doctors and hospitals you want to use are included.
A hospital's name or an insurance company's name alone is not enough to confirm coverage. The answer depends on your exact plan and the doctor or hospital.
Many people split care between two hospitals a few miles apart, and some spend summers away. Check both hospitals, and ask what a routine visit costs while you are out of town.
Nearby city guides: Culver City, Beverly Hills, Los Angeles.
What Is a Medical Group, and Why Does It Matter?
Some Medicare Advantage plans organize care through a medical group or doctor network. A medical group is a set of doctors who work together. That group may help arrange specialist visits and decide which hospital you use.
Ask your doctor's office which medical group your doctor belongs to and whether the group works with the exact plan you are considering. If you need a specialist, ask whether you need a referral or approval first.
A doctor who accepts Medicare does not necessarily accept every Medicare Advantage plan. Original Medicare does not use these medical-group lists the same way. A Medicare Advantage PPO may pay part of a visit to a doctor outside the list, but that does not mean every doctor is covered or that the visit will be inexpensive.
- UCLA physician practices and Providence-affiliated doctors are different groups.
Medical groups and doctor networks near Santa Monica
These are examples of medical groups that serve parts of the area. Your doctor may or may not belong to one of them. Call your doctor's office to confirm the medical group and ask which Medicare Advantage plans the doctor accepts. Then confirm the details with the insurance plan.
- Cedars-Sinai Medical Group. Doctors employed by Cedars-Sinai, on the Westside and in central Los Angeles.
- Cedars-Sinai Health Associates. Independent doctors who use the Cedars-Sinai name. This is not Cedars-Sinai Medical Group, which employs its own doctors.
- Providence Medical Associates. Providence’s medical group for the South Bay and the Westside.
- UCLA Medical Group. The medical group for UCLA Health clinics on the Westside, in the South Bay, and in the San Fernando Valley.
Community health centers
- Venice Family Clinic. A community health center on the Westside, including Venice, Culver City, and Santa Monica.
Broader medical groups also show up in Santa Monica: Angeles-IPA, HealthCare Partners Medical Group (Optum), and Optum Care Network–Los Angeles. A countywide medical group is still not your doctor’s group until the office says so.
- DoctorYour doctor
- Medical groupThe medical group
- HospitalThe hospital
With some Medicare Advantage plans, your medical group helps arrange referrals to specialists and hospitals. The process depends on your plan. Ask your doctor's office who handles referrals and whether you need approval before seeing a specialist. Your Medicare plan and your medical group has the longer explanation.
Check the Hospital You Want to Use
Think about where you would want to go for a planned procedure, specialist treatment, or hospital stay. Check that hospital against your plan, along with the doctors who would treat you there.
A hospital may belong to a larger health system, but that does not automatically mean every doctor or location in the system accepts your plan.
These are hospitals people in Santa Monica use. A name here is not a statement that any plan covers that hospital.
- UCLA Santa Monica Medical CenterIn-town UCLA campus. A UCLA doctor and a Providence doctor are two contracts.
- Providence Saint John’s Health CenterThe other in-town hospital. Do not assume it shares a list with UCLA.
- Cedars-SinaiNearby specialty care for some residents. Close does not mean the plan pays them.
- Nearby Cedars-Sinai for some specialty patterns.
- Coastal primary-care and independent specialty offices.
Look Beyond the Monthly Premium
A plan with a low monthly premium may still have costs when you visit a doctor, see a specialist, receive outpatient treatment, or stay in a hospital.
Before enrolling, compare the monthly premium, copayments, deductibles, prescription costs, and the maximum you could pay for covered medical services in a year. A copayment is what you pay at the visit. A deductible is what you pay before the plan starts sharing the cost. Also check whether your regular prescriptions are covered.
The right comparison depends on how you use healthcare—not just on which plan advertises the lowest premium.
Four Questions to Ask Before Changing Plans
Write down the answers and confirm important details with the insurance company. If you want help understanding your options, talk with Alan.
- Does my doctor accept this exact plan at the office I visit?
- Which medical group does my doctor belong to, and will I need referrals?
- Can I use my preferred hospital and specialists?
- What will I pay for my regular visits, prescriptions, and other care?
An example in Santa Monica
This is an example of what to check. It does not mean any doctor or hospital accepts a particular plan.
You use a UCLA primary doctor and a Providence specialist. The question is whether one kind of coverage can include both. My Medicare Checkup, then schedule a conversation if you want help comparing.
Senior and public resources
Resource links are provided for convenience. Medisure Agency is not affiliated with the listed agencies.
- Wise & Healthy Aging programs
- Big Blue Bus reduced-fare and Santa Monica Dial-A-Ride
- HICAP 1-800-434-0222 · County Aging 800-510-2020 · Medicare.gov · TTY 711
- Rides in Los Angeles County
- Medicare, HICAP, and Social Security
- Help paying Medicare costs
- Housing and utilities
Your healthcare resource map
The map shows hospitals and medical groups around Santa Monica. Add the doctor, hospital, and medical group you want to keep. A name here is not proof that a plan covers them.
City Hospital Health system Medical group ACCESS Senior help
Your focus
Santa Monica
This page is about Medicare decisions in Santa Monica. Nearby names only help if your coverage pays those doctors and hospitals.
Medicare in Santa MonicaAround Santa Monica
Communities
Cities drawn on this map, then the rest of Central and West Los Angeles.
- Santa MonicaHere
- Culver City
- Beverly Hills
- West Hollywood
- Los Angeles
- Inglewood
Hospitals and health systems are not the same thing
A hospital is a specific facility where you receive care. A health system may operate several hospitals and medical facilities. Check the exact location you want to use because coverage at one location does not automatically mean coverage at every location in the system.
Health systems
Hospitals
Medical groups and doctor networks near Santa Monica
These are examples of medical groups that serve parts of the area. Your doctor may or may not belong to one of them. Call your doctor's office to confirm the medical group and ask which Medicare Advantage plans the doctor accepts. Then confirm the details with the insurance plan.
Doctor groups and networks that help manage your care
- Cedars-Sinai Medical GroupMedical group · West · central Los AngelesDoctors employed by Cedars-Sinai, on the Westside and in central Los Angeles.For a referral, you usually ask the Medicare Advantage plan, not Cedars-Sinai Medical Group.
- Cedars-Sinai Health AssociatesPhysician network · West · central Los AngelesIndependent doctors who use the Cedars-Sinai name. This is not Cedars-Sinai Medical Group, which employs its own doctors.For a referral, you usually ask the Medicare Advantage plan. Do not assume these independent doctors follow the same rules as Cedars-Sinai Medical Group.
- Providence Medical AssociatesMedical group · South Bay · West Los AngelesProvidence’s medical group for the South Bay and the Westside.For a referral, you usually ask the Medicare Advantage plan. Confirm that this plan’s contract includes these Providence doctors.
- UCLA Medical GroupMedical group · West Los Angeles · South Bay · San Fernando ValleyThe medical group for UCLA Health clinics on the Westside, in the South Bay, and in the San Fernando Valley.The Medicare Advantage plan usually pays the bill. The plan may still ask UCLA Medical Group to confirm that the doctor is approved to see you.
Community health centers
Broader names
- HealthCare Partners Medical Group (Optum)Medical group · Los Angeles CountyThe older HealthCare Partners name is now used inside Optum. Ask the office which name is on your card.On many HMO plans, this group handles the referral and the approval before a visit. If the card says Optum, use the name the office confirms.
- Optum Care Network–Los AngelesMedical group · Los Angeles CountyOptum’s countywide Los Angeles medical group. A doctor in the San Gabriel Valley network is not automatically in this one.On many countywide Los Angeles HMO plans, this Optum group handles the referral, the approval before a visit, and much of the paperwork. It is a different list from the San Gabriel Valley Optum group.
Checked September 21, 2026.
Where to ask
These offices explain Medicare. They do not enroll you in a plan.
Questions people ask in Santa Monica
Can I keep both a UCLA physician and a Providence physician on the same Medicare arrangement?
Only if each named person participates—or if you use Original Medicare plus a Supplement with doctors who accept Medicare. Verify both offices.
Does PPO status guarantee UCLA Santa Monica access?
No. Confirm the exact physician, location, and plan. outside the plan's doctor list PPO care can cost more.
How does Medicare work during a long coastal or out-of-state stay?
Emergencies have protections. Routine visits may not. Map the months you are away before you compare extras.
Where can I get counseling that is not a plan sale?
California HICAP at 1-800-434-0222 is independent Medicare counseling. Medicare.gov and 1-800-MEDICARE (TTY 711) list every product in your ZIP.