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What is a Medical Group?​

A medical group is a group of doctors working in the same office or group of offices. These doctors have agreed to work together and usually share records and office systems. There are hundreds of medical groups in California.

Medical groups vs. health plans

A medical group provides your medical care and determines how you get it. Your health plan will contract with a medical group to serve its plan members. The health plan usually makes the rules for what types of your care are covered.

  • The doctors, nurses, therapists and other health professionals in the medical group work together to provide the care you need.
  • Your main doctor in a medical group may refer you to a specialist in the same medical group if you need specialist care for a health problem.
  • You may have a choice of medical groups in your area. Ask your health plan what medical groups you can go to.

Some medical groups work with more than one health plan. You may be able to  keep your doctor and medical group if you change health plans. Ask your doctor or medical group what other health plans they accept.

Choosing a medical group

Many health plans give you a choice of medical groups. Find out which medical groups in your area belong to your plan. When you compare these medical groups, here are some questions to think about and ask:

  • What is the quality of the medical group? Some medical groups and their doctors do a better job than others in providing quality care. Check OPA’s Medical Group Report Card for quality ratings.
  • Which doctors in the medical group are experts about my health problem?
  • Which hospitals do the doctors in the medical group use?
  • How much will I have to pay for the services that I use?
  • Are the medical offices nearby and easy for me to get to? Are they open during the hours that are good for me?
  • Who can I call if I need help or advice after hours?
  • Does the medical group have information and services online?