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Health Net Added Benefits
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About Health Net
Health Net is among the most respected health care
companies in California. They have an extensive network of 49,000
physicians, 750 physician groups and affiliates, and 4,400 pharmacies,
serving 2.5 million members in California for over 20 years. Health Net
offers 2 HMO plan options, 8 PPO plans and 1 EOA plan.
Health Net PPO Plans
About the Health Net PPO Value Basic 500
This is a catastrophic, major medical plan with a few extra
benefits. You are allowed 2 annual office visits for adults at a $30
co-payment without having to meet a deductible. Children are allowed 4
annual office visits. For other services, hospital and surgical benefits
there is a $500 deductible that applies. After the deductible you will pay
20% of the negotiated rate, up to an annual maximum of $3,500 has been
met. For other professional services, there is no benefit until the $3,500
annual maximum has been met, then they are covered in full. Prescription
benefits have a separate $100 annual deductible and a maximum $1,000
annual benefit.
About the Health Net - Net Saver 1500 PPO
This is a catastrophic major medical plan with prescription
benefits included. There are no office visit benefits until the maximum
annual out-of-pocket limit of $4,000 has been met. For most other services
there is a $1,500 annual deductible. After the deductible you will pay 25%
of the negotiated rate until the maximum annual $4,000 limit has been met.
Prescription drugs are not covered.
This plan is available by Internet only, to pass the savings on to you!
About the Health Net PPO Value Basic 1000
This is a catastrophic major medical plan with prescription
benefits included. There are no office visit benefits until the maximum
annual out-of-pocket limit of $3,000 has been met. For most other services
there is a $1,000 annual deductible. After the deductible you will pay 25%
of the negotiated rate until the maximum annual $3,000 limit has been met.
Prescription benefits have a separate $100 annual deductible and an annual
maximum benefit of $500.
About the Health Net PPO Value Basic 2500
This is a simple to understand catastrophic PPO plan.
Essentially, you will pay the first $2,500 in health care costs each year.
After you have met the deductible, you are covered in full for all
services except maternity that has an additional $1,250 deductible. This
plan does offer prescription benefits with a separate $100 annual
deductible without having to meet the annual $2,500 deductible.
About the Health Net PPO Value 25
This plan offers office visits for a $25 co-payment without
having to meet the annual deductible. There is a $1,000 annual deductible
for all other covered services, but this deductible is waived for
emergency hospital admittance. After the deductible has been met, you pay
25% of the negotiated rate up to the maximum annual out-of-pocket limit of
$4,000. There is an additional admittance fee of $250 for in-patient
hospital and out-patient surgical procedures.
About the Health Net PPO Value 30
This plan has an annual deductible of $2,500. Office visits
are $30 and do not apply to the annual deductible. For other covered
services, you will pay 30% of the negotiated rate after you have met your
annual deductible. Once your 30% share of cost reaches $4,500 (Includes
deductible), you are covered in full for the remainder of the calendar
year. There is an additional $250 admittance fee for hospital and surgical
procedures.
About the Health Net PPO Value 400
This plan has a low annual deductible of $400. There is a
separate $400 admission fee for hospital and surgical services. Office
visits and preventative health care are provided at a $40 co-payment. For
all other services, you pay 40% of the negotiated rate after the annual
deductible, up to an annual out-of-pocket maximum of $4,500.
About the Health Net PPO Value 750
This is Health Net's most comprehensive PPO plan. There is
an annual deductible of $750. Office visits are a $20 co-pay without
having to meet the deductible. For other covered services, you will pay
20% of the negotiated rate, up to an annual maximum of $3,500 (includes
deductible). There is an additional $250 co-pay for hospital and surgical
procedures.
Health Net HMO Plan
(Health Maintenance Organization)
About the Health Net HMO 15 Plan
The HMO 15 Plan has no annual deductible, unlimited
lifetime benefits, $15 office visits and 100% coverage for hospital and
surgical services after an annual hospital deductible of $1,000 Single,
$2,000 Family. This is the most comprehensive of all Health Net individual
health plans.
About the Health Net HMO 40 Plan
The HMO 40 Plan has a $2,000 annual deductible for
inpatient hospital services only. This deductible is waived for emergency
admittance into the hospital.For out-patient surgical procedures, you only
pay a $250 co-pay. The plan also offers unlimited lifetime benefits and
$40 office visits. Due to it's competive monthly premium, this is Health
Net's most popular HMO plan.
Health Net EOA Plan (Elect
Open Access)
About the Health Net EOA 15 Plan
The EOA plans provide the same comprehensive coverage of
the HMO plans, but also give you access to self-refer to any physician in
the PPO network for a co-payment of $35. When using the services of your
primary care physician, office visits and preventative health care are
provided for a $15 co-payment. Hospital and surgical benefits are provided
at 100% after an annual hospital deductible of $1,000 single, $2,000
annual deductible for families.
Added Benefits
WellRewards offers savings of
up to 50% off the suggested retail price of many products and services
designed for your good health, including vitamins and supplements, health
club memberships, weight control programs, home safety products, back care
products, eyewear and contact lenses and much more.
HealthLine is a 24-hour telephone
service that connects you to registered nurses for information and
guidance on health questions and will assess your symptoms and guide you
to the right care at the right time: emergency room, urgent care or your
doctor.
Wellness Programs provide Health Net
members with weight managements classes, diabetes and congestive heart
failure preventive seminars and many other learning opportunities.
Out-of-State Benefits
As is typical with any HMO plan, benefits provided by any
physician outside of the network of your primary care physician are only
available in an emergency situation where you do not have access to your
primary medical group. This includes emergencies outside the State of
California.
Waiting Periods
The Health Net HMO plans have no waiting periods for
pre-existing conditions.
Enrollment Process
Enrollment requires the completion of a somewhat lengthy
and detailed health questionnaire. You may apply online, download an
application, or request a detailed plan brochure and application. A
refundable deposit in the amount of the first month's premium must be
included along with the completed application.
For additional help... Call us toll-free at
1-949-394-7676
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