SIMPLIFIED PAYER SOURCE MAP

Medicare Benefit Plan

Part A (Hospital)

Part B (Outpatient)

Part C (Replaced by HMO)

Part D (Prescription)

Medi-Cal Benefit Plan

Full Scope Medi-Cal

Medi-Cal Share-of-Cost

Restricted Medi-Cal

Out-of-County Medi-Cal

Other Funding Sources

CalWORKS

Conservator

County General Fund

ERMHS

Human Service Agency

DHS Work Order

MHSA

SAMHSA

Uninsured

Patient Fee Liability

UMDAP Sliding Fee

Full Service Cost

Covered CA Benefit Plan

Anthem Blue Cross

Blue Cross of CA

Chinese Community HP

Kaiser Permanente

Health Net

Private Health Plan

Aetna

Anthem Blue Cross

Blue Shield of CA

Cigna

Health Net

Kaiser Permanente

United Health Care

Provider Health Plan (Managed Care Plan)

San Francisco Health Plan

Anthem Blue Cross Plan

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