Insurance & Coverage

Uninsured

Lyon-Martin will never turn any client away for lack of ability to pay. We do not send anyone to collections for failing to pay bills. Clients without insurance will be asked to apply for our sliding scale, which allows for low-income clients to be billed at small flat rate fee based on income. If you do not have any income documentation, you may sign a letter self-attesting your income.

We can enroll clients who are uninsured into coverage programs such as Healthy San Francisco, Family Planning Access Care and Treatment (FPACT) and/or Every Woman Counts (EWC) to help pay for the cost of services at our clinic and for some referrals for specialty care. 

Medicare & Medi-Cal

We are in-network with:

• Medicare
• Medicare/Medi-Cal
• Medi-Cal (fee for service, regular or “straight” Medi-Cal)
• Medi-Cal Managed Care Plans
  • San Francisco Health Plan Medi-Cal & Beacon, SFHP’s Mental Health Coverage plan
  • Anthem Blue Cross Medi-Cal
  • Health Plan of San Mateo Medi-Cal

We also accept, but are out-of-network with, any additional out of county Medi-Cal plans such as

• Health Plan of San Joaquin Medi-Cal
• Partnership Health Plan Medi-Cal
• Alameda Alliance Medi-Cal
• Contra Costa Health Plan Medi-Cal
• California Health & Wellness Medi-Cal
• Molina Healthcare Medi-Cal
• Inland Empire Medi-Cal
• LA Care Medi-Cal

and more; however, referrals to specialists may be a bit more difficult to navigate with out of county plans since we are out of network. If you are able to obtain insurance approval to come to us, or obtain “special member’s status”, we can make referrals to specialists more easily.

Commercial PPO, EPO, & HMO Plans

We are in-network with:

• Blue Shield of California PPO, EPO, HMO
• Anthem Blue Cross of California PPO, EPO, HMO (Brown & Toland)
• Cigna PPO, EPO, HMO & Evernorth, Cigna’s Mental Health Coverage plan
• Aetna PPO, EPO, HMO
• United PPO, EPO, HMO
• Landmark (for Acupuncture only)

We accept, but are out-of-network with:

• Health Net PPO

When we accept a particular insurance but are out-of-network, your insurance will pay for your care at the out-of-network rate rather than the in-network rate, which means you may be responsible for a larger portion of cost of your care. Any deductible or co-pay you are unable to pay for services received at our clinic can be paid at a sliding scale rate if you are eligible based on income. Again, we never turn anyone away for lack of funds and will never send anyone to collections for not paying bills for our services.

Kaiser HMO

We are not in-network with any additional private, commercial EPO or HMO plans, including Kaiser. While you can still obtain care with us at the out-of-network rate, Kaiser will likely not cover any portion of your care with us unless it is pre-authorized by Kaiser. Any deductible or co-pay you are unable to pay for services received at our clinic can be paid at a sliding scale rate if you are eligible based on income. Again, we never turn anyone away for lack of funds and will never send anyone to collections for not paying bills for our services.

**It is important to note, however, that obtaining care from an out-of-network clinic like ours with an EPO or HMO plan like Kaiser can make it difficult or sometimes impossible for us to refer you to specialists that your insurance will cover and sometimes difficult or impossible for us to prescribe medications that your insurance will cover. Many EPOs and HMOs only accept referrals or prescriptions from in-network primary care clinics. Check with your insurance company first to see if our referrals and prescriptions can be covered.