About Western Health Advantage

Western Health Advantage has a passion for health care. The organization is committed to delivering quality care to employers and employees, while supporting medical innovation and promoting improved health to suit the diverse needs of Northern California. For more than 25 years, Western Health Advantage has been a reliable partner to businesses and employees – helping thousands of Californians stay healthy and establish a long-term relationship of trust with their physicians.

Consistently recognized for delivering member value, Western Health Advantage has a provider network that includes major hospitals and medical centers and thousands of doctors and specialists in its 14 county service area: Alameda, Colusa, Contra Costa, El Dorado, Marin, Napa, Placer, Sacramento, San Francisco, San Mateo, Santa Clara, Solano, Sonoma, and Yolo counties.

Quick Plan Highlights

Below are some of our most popular Western Health Advantage health plans along with a snapshot of plan coverage and out-of-pocket costs. For a complete list of coverage options, click Download All Plans below to see the most current plan information.

These plans are effective beginning: 1/1/23

Bronze HMO B

Network	Full
Calendar Year Deductible	$6,300 / $12,600 (applies to Max OOP)
Out-of-Pocket Max Ind/Fam:	$8,200 / $16,400
Dr. Office Visit (PCP):	$65 Copay
Urgent Care:	$65 Copay
Emergency Room	60%

Silver HMO A

Network	Full
Calendar Year Deductible	$2,300 / $4,600 (applies to Max OOP)
Out-of-Pocket Max Ind/Fam:	$8,750 / $17,500
Dr. Office Visit (PCP):	$50 Copay (ded waived)
Urgent Care:	$100 Copay
Emergency Room	70%

Gold HMO A

Network	Full
Calendar Year Deductible	100%
Out-of-Pocket Max Ind/Fam:	$6,750 / $13,500
Dr. Office Visit (PCP):	$40 Copay
Urgent Care:	$100 Copay
Emergency Room	$300 Copay

Platinum HMO A

Network	Full
Calendar Year Deductible	100%
Out-of-Pocket Max Ind/Fam:	$4,000 / $8,000
Dr. Office Visit (PCP):	$25 Copay
Urgent Care:	$50 Copay
Emergency Room	$150 Copay

Bronze HMO B

Network	Full
Calendar Year Deductible	$6,300 / $12,600 (applies to Max OOP)
Out-of-Pocket Max Ind/Fam:	$8,200 / $16,400
Dr. Office Visit (PCP):	$65 Copay
Urgent Care:	$65 Copay
Emergency Room	60%

Silver HMO A

Network	Full
Calendar Year Deductible	$2,300 / $4,600 (applies to Max OOP)
Out-of-Pocket Max Ind/Fam:	$8,750 / $17,500
Dr. Office Visit (PCP):	$50 Copay (ded waived)
Urgent Care:	$100 Copay
Emergency Room	70%

Gold HMO A

Network	Full
Calendar Year Deductible	100%
Out-of-Pocket Max Ind/Fam:	$6,750 / $13,500
Dr. Office Visit (PCP):	$40 Copay
Urgent Care:	$100 Copay
Emergency Room	$300 Copay

Platinum HMO A

Network	Full
Calendar Year Deductible	100%
Out-of-Pocket Max Ind/Fam:	$4,000 / $8,000
Dr. Office Visit (PCP):	$25 Copay
Urgent Care:	$50 Copay
Emergency Room	$150 Copay

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