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Health Net CA Silver, Bronze, Platinum & Gold Plans
Individual & Family Plan Information 

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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.

Brochures

2023 Disclosures

2023 – Ambetter PPO Disclosure for Covered California

2023 – Ambetter HMO Disclosure for Covered California

2023 Pediatric Dental and Vision

  • 2023 – Pediatric Dental and Vision (Ambetter HMO)
  • 2023 – Pediatric Dental and Vision (Ambetter PPO) 

 

BROKER ONLY

ifp.health net california.com/Plan_Materials

 

Brochures

Enrollment Tools

2023 Disclosures

Dental and Vision

  • 2023 – Adult Dental and Vision Coverage with HMO Health Plans (PDF)
  • 2023 – Adult Dental and Vision Coverage with PPO Health Plans (PDF)
  • 2023 – Pediatric Dental and Vision (Ambetter HMO) (PDF)
  • 2023 – Pediatric Dental and Vision (Ambetter PPO) (PDF)

Plan Overviews

Get your ID Card and don't worry about money $$$ or going bankrupt when you might visit the hospital or doctors office

Sample Ambetter ID Card

Covered CA Certified Agent

#Covered CA Certified Agent  

No extra charge for complementary assistance 

I'm in Sonia

 

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 *

What Doctors & Hospitals take 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.

  • 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

Health Net Choose MD

 

Pharmacy

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).
      • 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.
      • 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

#Dental and Vision

Email us [email protected]

#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 

Why you need Group Dental Coverage

 

Steve on buying, shopping and best use of premium dollars
Dental Insurance VIDEO

steve's video on dental coverage

MORE VIDEOS

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.

Wellness Incentive

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

 

Health Net Medi-Cal
No-cost and #Low-cost Coverage for Californians

Health Net Medi-Cal Website

Health Net Commercial - Medi-Cal

Medi-Cal provides free and low cost health care coverage for low income adults, families, children regardless of immigration status, older adults, and people with disabilities.

All children that meet the Medi-Cal eligibility requirements, regardless of immigration status, can get comprehensive health care in Health Net Medi-Cal.

Medi-Cal Managed Care HMO – Health Care Options 

#Pick your Plan

Here you can review and choose the HMO that you want to deliver your Medi-Cal health Care.

Medi Cal Provider HMO Selection Website

learn choose enroll medi cal plans

Learn more:

Brochures

2022 Pediatric Dental and Vision

4 comments on “Health Net 2023 Individual Information & Enroll

  1. 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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