Health Net CA 2021 Plan Information Direct

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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.

2021 Brochures and Information

 

Broker ONLY

https://ifp.healthnetcalifornia.com/brokers/brkr-faq.html

https://ifp.healthnetcalifornia.com/health-plans/Plan_Materials.html

Introducing Heal

Heal is a service that provides primary, preventive and urgent care appointment at home, office or hotel for PPO members.

Appointments are available from 8:00 a.m. to 8:00 p.m., seven days a week, in select urban areas. Members can check the eligibility of any address at heal.com/healthnet.

Here are the benefits members get with Heal:

  • A doctor and a medical assistant at every visit.
  • The option of having anyone covered by a member’s PPO health plan seen by the doctor in one Heal visit.
  • The same out-of-pocket costs as a doctor’s office visit. If more than one covered person is seen at the same visit, each one pays the same charge as a doctor’s office visit.
  • A more convenient option for non-emergency situations than urgent care centers or emergency rooms.

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Covered CA Certified Agent  
No extra charge for complementary assistance 

Videos on how great agents are

Enrolling in health plans has helped people focus on their families and careers, and feel protected against unexpected medical issues.

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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:

* Purchased through Covered California™, a broker or directly from Health Net.

Important Pharmacy Information

It’s a normal part of life to rely on a prescribed drug or product. Whether it’s for you or a family member, you’ll want to find the right medicine for the right price – at the most convenient location.

Pharmacy Benefits

Wellness Incentive –

Earn $50 by doing a health questionnaire and visiting your doctor.

 

Glossary of Health Coverage and Medical Terms – English (PDF)

Health Net ONLINE
Provider Search Finder

Welcome Provider Search

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.

How to tell HN what MD - PCP you want in your Member Portal

Health Net Choose MD

 

Pharmacy

HN #Network Definitions

  • 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).
  • 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.
  • 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.
  • 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 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

Summary of Benefits and Coverage (SBC) 2021
#Covered CA 

EnhancedCare PPO

PureCare One EPO

PureCare HSP

Broker ONLY

https://ifp.healthnetcalifornia.com/health-plans/Plan_Materials.html

Broker ONLY

https://ifp.healthnetcalifornia.com/health-plans/Plan_Materials.html

10 comments on “Health Net 2021 Individual Information & Enroll

  1. 3 comments on “Provider Networks & Search”

    1. my Health Net Physicians Group is Scripps Coastal Medical Center as my Primary Care. Is their lab in the Health Net Community Care HMO network?

      Reply
  2. 2019 Essential Rx List
    ifp dot
    healthnetcalifornia.com/content/dam/centene/healthnet/pdfs/general/ca/pharmacy/ca_essential_rx_list_2019.pdf

    Drug coverage explained in Evidence of Coverage
    ifp.healthnetcalifornia com/content/dam/centene/healthnet/pdfs/general/ca/ifp/eoc/2019-ca-ifp-bronze-60-ec-ppo-eoc.pdf#page=130

    • Is this what you’re looking for?

      Prevention 2019 Calendar and Health Planner, you’ll get all the tools you need to drop the pounds, burn away your most stubborn trouble spots, stay motivated all year round, and feel healthier than ever before!

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  3. 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.

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