Authorized Agent
Health Net CA Silver, Bronze, Platinum & Gold Plans
Individual & Family Plan Information
- Health #Net of California Authorized Agent - Broker
- Employer Small Group Instant Quotes Health Net
- No Extra Charge for our services & consultation along with 17 Benefits that you get when you select us as your agent/broker!
- Email us [email protected] for more information.
2025 Information
Materials & Forms
Brochures
- 2025 – Plan choices by location – English (PDF) (IFP on- and off-exchange)
- 2025 – IEX Sales Brochure – English (PDF)
- 2025 – IEX Sales Brochure – En Español (Spanish) (PDF)
- 2025 – IEX Ambetter HMO Sales Brochure – English (PDF)
- 2025 – IEX Ambetter HMO Sales Brochure – En Español (Spanish) (PDF)
- 2025 – IEX Ambetter PPO Sales Brochure – English (PDF)
- 2025 – IEX Ambetter PPO Sales Brochure – En Español (Spanish) (PDF)
2025 Disclosures
Ambetter HMO
Ambetter PPO
2025 Pediatric Dental and Vision
Brochures
- 2025 – Plan choices by location – English (PDF) (IFP on- and off-exchange)
- 2025 – IFP Sales Brochure – English (PDF)
- 2025 – IFP Sales Brochure – En Español (Spanish) (PDF)
Enrollment Tools
Individual & Family Plans (IFP) Enrollment Applications –
Effective January 1, 2025
Please come back November 1, 2024 for our 2025 Enrollment Applications.
2025 Disclosures
Ambetter HMO
Ambetter PPO
Dental and Vision
Get your ID Card and don't worry about money $$$ or going bankrupt when you might visit the hospital or doctors office
#Covered CA Certified Agent
No extra charge for complementary assistance
- Get Instant Health Quotes, Subsidy Calculation & Enroll
- Appoint us as your broker
- Get Instant Health Quotes, Subsidy Calculation & Enroll
- Videos on how great agents are
Health Insurance unfortunately is very complicated
President Trump February 27, 2017
- Thus, if we haven't simplified and explained in PLAIN ENGLISH what you are looking for:
Provider Search & Network Definitions
What Doctors & Hospitals take Health Net
ONLINE Provider #Search Finder
- Network Definitions
- Instructions to use HN Provider Search Tool
- MHN Mental Health Provider Look Up
- VIDEO Health Plan Networks
- Out of Area PPO Network Member Flyer FAQ's Group plans
Know Where to Get Care
Doctors, nurses, advice lines, urgent care centers. It’s not always easy to know where to go for the care you need. Health Net has you covered! Learn about your care choices, recommendations on when to use them and how! It’s all in the Care Key designed for your health plan.
Just find your Health Net health plan in the list below. (Your plan type is listed on your Health Net ID card.) Click on the first link beneath your plan name to review your detailed Care Key.
- Health Net CommunityCare HMO – Care Key
- Health Net PureCare HSP – Care Key
- Health Net PureCare One EPO – Care Key
- Health Net PPO – Care Key
- Health Net EnhancedCare PPO – Care Key
How to tell HN what MD - PCP you want in your Member Portal
HN #Network Definitions
- Preferred Provider Organization (PPO):A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.
- Health Maintenance Organization (HMO):A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
- Health Plan Types & Networks The difference between in-network and out-of-network VIDEO
- Plans that don’t seem to be offered for 2023 Individual & Family
- Exclusive Provider Organization (EPO):A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
- In the United States, an exclusive provider organization is a hybrid health insurance plan in which a primary care provider is not necessary, but in which health care providers must be seen within a predetermined network. Out of network care is not provided, and visits require pre-authorization. Doctors are paid as a function of care provided, as opposed to an HMO. In an EPO, the payment scheme is usually fee for service, in contrast to HMOs. In the latter, the healthcare provider is paid by capitation, and receives a monthly fee regardless of whether or not the patient is seen.[1] healthcare.gov/exclusive-provider-organization-epo-plan/ healthcare.gov/plan-types/
- Point of Service (POS):A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans require you to get a referral from your primary care doctor in order to see a specialist.
- A Health care service plan (HSP) Pure Care Network in Southern California (on- and off-exchange).
- Health Care Service Plan (HSP) is a benefit plan using health care provider arrangement whereby an entity, such as Health Net, contracts with a group of Physicians or other medical care providers, called Participating Providers, who agree to furnish services at the negotiated rate known as the Contracted Rate. Bronze EOC Page 119
- Health Net PureCare HSP Service Area is the geographic area in California where Health Net has been authorized by the California Department of Managed Health Care to contract with providers, market products, enroll Members and provide benefits through approved Individual HSP health plans. A listing of the Participating Providers in the Health Net PureCare HSP Service Area, including Primary Care Physicians, are available on the Health Net website at www.healthnet.com. You can also call the Customer Contact Center at the number shown on your Health Net I.D. Card to request provider information. Bronze EOC Page 119
- Health Care Service Plan (HSP) is a benefit plan using health care provider arrangement whereby an entity, such as Health Net, contracts with a group of Physicians or other medical care providers, called Participating Providers, who agree to furnish services at the negotiated rate known as the Contracted Rate. Bronze EOC Page 119
- Get Instant Health Quotes, Subsidy Calculation & Enroll
Dental & Vision
#Importance of Dental Coverage
Dental & General Health
Insurance 101?
We suggest that you check out Life Insurance, Disability, Long Term Care and Retirement as these risks may cause much more financial devastating to your budget than dental bills.
Picture of Oral Health
- Dental For #Everyone, Instant Quotes - Online Enrollment
-
Delta Dental - Get Quotes & Enroll
- Dental care reduces likelihood of hospitalization for people with diabetes or coronary artery disease Medical Press 5.6.2022
- The 2022 State of America’s Oral Health and Wellness Report Commissioned by Delta Dental Plans Association
- What drives buyers of individual Delta Dental plans?
- 77 Million Adults Do Not Have Dental Insurance
- CDA-sponsored bills seek more protections, increased oversight of dental insurance Bills would prohibit plans from imposing arbitrary waiting periods, denying coverage for preexisting conditions; require rate review and ERISA notice Learn More >> CDA * CA Legislature * California Benefits Review Program *
Steve on buying, shopping and best use of premium dollars
Dental Insurance VIDEO
MORE VIDEOS
- What dental Insurance... should I buy???
- VIDEO the dentist attempts to give you some guidance about things to consider before buying a dental insurance plan, finance plans available, negotiating with your dentist
- Sacramento Truck driver sudden dealth from tooth infection Sacramento Bee 1.31.2017
- Health Savings Accounts?
- Video - how bad sugary drinks are for you
Member Portal & Video Library
Health Net Member #Portal
Keep Track of Your Coverage
Manage your health the easy way. Through the member portal, you can access the following tips and tools to make things easy on yourself.
- Check coverage information. Have a glance at the benefits offered to you and your family. Or, download full coverage documents.
- Find a doctor. Provider Search easily lets you search by health plan or location. And you're not limited to searching for a doctor. You can look for dental, vision, alternative, and other providers – plus hospitals and care centers near you.
- Find a pharmacy. Use the Pharmacy Locator to find a retail pharmacy close to your home.
- Make a premium payment. Access three easy ways to pay – online, by mail or by phone. Watch Video! 2 Tips – Paying Your First Premium Payment
- Print and order ID cards. Need a new ID card? Print a replacement card quickly online or order a new card by mail.
- View claims, approvals and download forms. See a record of the services you've had. Find out if your approval has gone through, or download forms you need for your plan.
Secure Access to Tools
Get a Health Net username and password for our member portal. Choose your plan type to register an account:
- Member Registration – Medi-Cal
- Member Registration – Individual and Family Plans*
- Member Registration – Employer Plans
- Member Registration – Medicare
- All other plans
- Video on setting up an account ** Things on healthnet.com
* Purchased through Covered California™, a broker or directly from Health Net.
#TeleMed
This is our "Main Module" on Telemed. Not just one specific Company but Telemed for ALL companies, in general.
- CMS won't extend certain key pandemic-era Medicare telehealth expansion plans.
- Teleheath for Medicare may end without congressional action November 2024
- Telehealth has quickly become one of our nation’s most essential health care services — a safe and low-cost way to access care.
- Millions of users have now experienced and embraced what telehealth has to offer. Many won’t go back to traditional ways of getting care, including your employees. To meet the evolving preferences of your workforce, you should offer a health plan with connected virtual care options. Learn More: Kaiser *
- Oscar covers Medically Necessary Covered Services offered through Telehealth by an In Network Provider subject to the terms and conditions of the their contracts with In Network Providers. Telehealth Visits from certain Oscar-designated Telehealth Providers are covered in full.
- Telehealth Visits can be requested through Oscar’s website, mobile application, and their customer service line 1-855-672-2755.
- Health Net Teladoc Medicare
- Teladoc (Telehealth) Introductory Flyer
- Teladoc (Telehealth) FAQs
- Teladoc (Telehealth) FAQs – En Español
- Teladoc Caregiver flyer
- Teladoc Caregiver FAQs
- hioscar.com/doctor-on-call
- Doctor On Demand.com
- hioscar.com/need-medical-advice-call-a-doctor-instead-of-your-mom
- EOC – Evidence of Coverage.
- Tele Med VIDEO Oscar
- OSCAR Tele Med 1 page flyer
- My CPA’s thoughts & research on Telehealth
- U.S. saw significant drop in telehealth use last year after rapid growth in 2020 Modern Health Care *
- Telehealth Companies Want Congress to Make Pandemic Expansion of Their Services Permanent Time Magazine 4.2022 *
- FAQs on Medicare Coverage of Telehealth
- Dental Visits Tele Health
Further clarification from Oscar:
- Our Doctor on Call benefit is on all Oscar plans and include Oscar physicians that are board certified in your state.
- These physicians are not specialists, they generally are listed as Internal Medicine, Primary Care, etc.
- These doctors are not found on our website because there is no way to visit/select which doctor you speak to.
- The physicians often service multiple states, as they are generally certified in multiple.
- Personally, when I used the Doctor on Call benefit (at 11 pm) the doctor called me within 10 minutes.
- If I called again today I would likely be speaking to a different physician.
- I checked with Oscar circa 4.4.2019 and their Tel Med is just for an initial visit. Check our Coronavirus page for updates on that.
- doctor on demand.com
- Emotional support helpline: 1-866-342-6892 – Optum
- AB 744 - TeleHealth
- AB 744 will require contracts issued, amended or renewed after January 1, 2021 between a health care service plan and a health care provider to specify that the provider who delivers services appropriately through telehealth be reimbursed on the same basis and to the same extent that the plan would have had the same service been provided in-person. The health plan cannot require the use of telehealth if the health care provider has determined that it is not appropriate nor does it limit the ability of the health plan and provider to negotiate the rate of reimbursement for a service. TeleHealth Resources.org *
- LA Times on Tele Med 8.2018
-
telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
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Telehealth is different from telemedicine because it refers to a broader scope of remote healthcare services than telemedicine. While telemedicine refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.
- AMA outlines key steps for advancing telehealth equity
- Telehealth didn't lead to unnecessary care in 2020, study says
- I checked with Oscar and their Tel Med is just for an initial visit.
- Here's what I googled for online therapists. Check with them and ask what Insurance Plans they take. Then double check on the official Insurance Company provider list.
Health Net Video Library
Who does what in Health Care
MORE VIDEO’s and a few pdf’s
- Paying Less for Health Coverage
- RENEWING YOUR COVERAGE
- The Right Fit
- Know your health coverage costs
- The Right Health Plan for You HMO or PPO, etc?
- Value of Health Coverage 2 pages
- Who does what in Health Care
- Staying Covered when your life changes
- In Network Out of Network – What is a network?
- Know your coverage costs
- Co-Insurance? UHC
HN Coinsurance - Cost Sharing Reductions – Enhanced Silver
- Players & Terms
- Renewing your Health Coverage
- Guides, Tools, Options to get Health Insurance
- Health Net – Glossary of Health Coverage & Medical Terms
- Health Net’s YouTube channel
Business Ethics & Code of Conduct
Broker ONLY
https://ifp.healthnetcalifornia.com/brokers/video-library.html
Historical
- Ambetter Health Net Direct Brochure
- Steve’s Introductory VIDEO 2021 version
- VIDEO Learn more about key benefits
- Covered CA Plans 2023
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- 2024 – IEX Sales Brochure – English (PDF)
- 2024 – IEX Ambetter HMO Sales Brochure – English (PDF)
- 2024 – IEX Ambetter PPO Sales Brochure – English (PDF)
2024 Disclosures
Ambetter HMO
Ambetter PPO
PPO Change???
Health Net’s full PPO that is offered off exchange – direct, not Covered CA is being closed with no replacement product. The Ambetter PPO that is regulated by the CDI – CA Department of Insurance is being closed, however, we are introducing Ambetter PPO under the DMHC Department of Managed Health Care. The plans and network are the same as the existing Ambetter PPO. This is really just a regulator change. Email dated 10.26.2022 *
Covered CA Broker Bulletion
Reminder: Health Net Changes for Plan Year 2023
Starting January 1, 2023, Health Net Life Insurance Company will no longer offer its Individual & Family Ambetter PPO and EPO plans through Covered California. In addition, Health Net of California will no longer offer its Ambetter HSP plans through Covered California – Health Net of California will remain on the exchange and will offer replacement plans as applicable.
Impacted households were sent a notice with information about 2023 coverage and instructions for updating their Covered California application and selecting a new plan. Eligible members will be automatically enrolled into a similar Health Net of California plan within the same metal tier – Health Net Life PPO members will be automatically enrolled into the Health Net of California PPO plan. If a Health Net of California plan is not available, then the lowest cost, most similar plan with another issuer in their area will be chosen; EPO members will be moved to a different issuer in the member’s area.
You can choose to enroll in a different plan by December 31 for a January 1 start date. Impacted consumers may also qualify for a 60-day Special Enrollment Period (SEP) due to loss of coverage. The SEP ends on March 1, 2023. If consumers don’t enroll in a new plan by that date, they will have to wait until the next Open Enrollment period to get health coverage – unless they experience a Qualifying Life Event.
- Ambetter Health Net Direct Brochure
- Steve’s Introductory VIDEO 2021 version
- VIDEO Learn more about key benefits
- Covered CA Plans 2023
-
- 2024 – IEX Sales Brochure – English (PDF)
- 2024 – IEX Ambetter HMO Sales Brochure – English (PDF)
- 2024 – IEX Ambetter PPO Sales Brochure – English (PDF)
2024 Disclosures
Ambetter HMO
Ambetter PPO
2023 Preview
- Health Net Closes Their Full Network PPO Health Plan –
- Starting January 1, 2023, Health Net Life Insurance Company will no longer offer its Individual & Family Ambetter PPO and EPO plans through Covered California. In addition, Health Net of California will no longer offer its Ambetter HSP plans through Covered California – Health Net of California will remain on the exchange and will offer replacement plans as applicable.
- Covered California will send each impacted household a notice with information about 2023 coverage and instructions for updating their Covered California application and selecting a new plan. Eligible members will be automatically enrolled into a similar Health Net of California plan within the same metal tier. If a Health Net of California plan is not available, then the lowest cost, most similar plan with another issuer in their area will be chosen – EPO members will be moved to a different issuer in the member’s area. Consumers can choose to enroll in a different plan by December 31 for a January 1 start date.
- Impacted consumers may also qualify for a 60-day Special Enrollment Period (SEP) due to loss of coverage. The SEP ends on March 1, 2023. If consumers don’t enroll in a new plan by that date, they will have to wait until the next Open Enrollment period to get health coverage – unless they experience a Qualifying Life Event aka Special Enrollment broker bulletin from Covered CA *
- Learn more – Insure Me Kevin.com
Thank you so much for all of your assistance. Happy holidays
Does Health Net offer plans for individuals that include PPO reimbursements when seeing doctors/hospitals/etc even if I go to those who aren’t part of the Health Net plan.
For example, my psychologist is not affiliated with any plan, but in the past some percentage was still covered by insurance.
Yes. IMHO the best way to find PPO plans would be to use either Health Net’s Quote and Enrollment Engine shown above or our Quotit Engine that gives you quotes from all companies
Check our Definitions Page for a sample of how in network and out of network providers get paid and what % you pay