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Health Net News

Health Net Changing Blood Glucose Meters, Test Strips Coverage

The covered brand will transition to Roche Accu-Chek^® and Abbott FreeStyle^® meters and test strips.

Key Changes:

• OneTouch^® meters and test strips will no longer be covered at Tier 2 beginning January 1, 2026.
• Members who remain on OneTouch^® may continue to do so, and claims will process at Tier 3.
• No prior authorization will be required for members who continue on OneTouch^® (grandfathered).

Transition Timeline

• December 1, 2025: Members may begin obtaining preferred Accu-Chek^® or FreeStyle^® meters and test strips at the pharmacy.
• January 1, 2026: OneTouch® test strips will process under Tier 3 coverage.

Recommended Member Actions

To support a smooth transition during year-end and holiday periods, members are encouraged to:

• Request a new prescription in December 2025 for preferred products.
• Present their notification letter to their pharmacist for assistance.
• Consider a 90-day supply through mail order or Maintenance Choice.

Member Notification

• Impacted members received a mailed notification by November 1, 2025, detailing preferred options, transition steps, and support resources.

_{¹ Accu-Chek^® and FreeStyle^® flyers with information on how to obtain a meter at no cost will be posted by December 1, 2025 in the Pharmacy section on Health Net and MyHealthNetCA.}

Sign Up for Health Net's Market Insights February Webinar

Industry Insights to Enhance Your Business

We’re pleased to invite you to the February session of our quarterly Health Net Market Insights Webinar Series.

Join Alyson and her special guests for a discussion packed with priceless information straight from the experts.

Glean valued strategies in thought leadership and explore the latest healthcare trends. All designed to help you to gain new and dynamic insights and stay informed about current industry developments. In this webinar you’ll learn about the latest:

California AB 3275 to Establish Uniform Claim Reimbursement Standards

New standards to go into effect January 1, 2026

Beginning January 1, 2026, California law (AB 3275) will establish uniform claim reimbursement standards for all health care service plans and health insurers, which include Medi-Cal managed care plans.

Under this new law, plans must reimburse, contest, or deny complete (clean) claims within 30 calendar days of receipt. The prior standard of “working days” is replaced with calendar days.

If a claim is contested or denied, plans are required to send a written notice within 30 calendar days, explaining the reason for the action and any next steps.

This rule applies to all claims received on or after January 1, 2026, across both Department of Managed Health Care (DMHC)- regulated and Department of Insurance (DOI)-regulated lines of business.

Key changes at a glance

• 30 calendar days to pay, contest or deny a complete claim — applies to health care service plans regulated by DMHC and DOI.
• If additional information is requested and submitted, the plan has 30 calendar days from receipt of the new information to re-adjudicate the claim.
• Written notice of contest or denial must be issued within 30 calendar days, clearly outlining the reason and next steps.
• Late payments:
  • Claims not paid within 30 calendar days will accrue interest at 15% per annum, starting on the 31st day.
  • Plans must automatically include all accrued interest in the payment — no separate request is required.
  • If interest is not automatically included, a penalty of no less than 10% of the accrued interest, or $15 (whichever is greater) applies.
  • Interest amounts under $2 may be aggregated and paid monthly, accompanied by an itemized list of claims.
• Provider disputes:
  • Determinations are due within 45 working days.
  • If the provider prevails, payment (including all interest and penalties) must be made within 5 working days.

Our commitment and next steps

• The plan has an active internal workgroup in place to ensure full implementation of AB 3275/APL 25-007 by January 1, 2026.

In the Community

United Way California Capital Region

Darsey Varnedoe Jr., Public Affairs & Community Investments Representative and Amy Krause, VP, Associate General Counsel, proudly represents Health Net on United Way’s Board of Directors.

Health Net and United Way California Capital Region have a longstanding, productive, partnership making a difference in the community.

Recent projects include:

• A Health Net grant to help cover local housing deposits for the unsheltered and increase the use of housing-related community support services.
• Expansion of United Way’s Kinder Camp program. With Health Net’s help, Kinder Camp is adding health and wellness services. This means kids will start school ready to learn and stay healthy.

Darsey stated why she supports United Way. “I’m a United Way champion because they meet people at life’s most vulnerable moments—with compassion, resources and real solutions.

"An example: A mother was recently helped through UW’s housing support program. She was living in her car with her two children. With help from our Health Net grant, United Way covered her housing deposit and connected her to services that gave her family stability and hope.

"That’s the kind of impact United Way makes every day. Whether it is helping kids start school healthy and ready to learn through Kinder Camp, or supporting families in crisis, they’re building stronger, healthier communities.

"I believe in that mission—I’ve seen the difference it makes.”

Wellness

December Wellness Webinar – Be Well in Winter

Health Net members have access to complimentary wellness programs via our secure website. To access, register online and begin by taking the RealAge Test (health assessment) to identify your health score. Enjoy a variety of wellness programs, health challenges and wellness activities to help you stay healthy. Members can get access to more wellness tips and programs by visiting our Wellness page.

Just For Fun

1. Cruise the light displays: Whether simple or over-the-top, neighborhood lights are hard to resist. Drive or walk through nearby streets for inspiration—and maybe a few ideas for next year.
2. Host a holiday open house: A casual open house lets you reconnect with friends, neighbors, or colleagues without the stress of a formal dinner. Keep it simple—or tie it to a local charity.
3. Add a little movement: Balance holiday treats with a winter workout. Join a fitness challenge, meet a friend at the gym, or simply take brisk walks between gatherings.
4. Visit elder communities: Long-term care residents often appreciate extra company this time of year. Consider joining or organizing a group to visit, sing, or help with activities.
5. Care for winter wildlife: Feeders offer birds a lifeline during cold months. Put out suet, fruit, or seed, and keep water unfrozen so wildlife has reliable access to nourishment.
6. Support local food banks: Turn giving into a family tradition. Donate essentials, volunteer together, or learn how you can make a difference year-round.
7. Try full-moon fun: If you have access to snow, full-moon skiing or snowboarding creates a magical winter memory. No snow? Try a moonlit walk or run instead.
8. Read a holiday classic: December is perfect for cozy reading. Go solo or choose a title with a book club—Dickens’ A Christmas Carol remains a seasonal favorite.
9. Create handmade gifts: Crafting adds meaning to gift-giving. Make calendars, artwork, or family keepsakes—or record interviews with older relatives to preserve stories.
10. Join the Annual Bird Count: The Audubon Society’s annual bird count (December 14, 2025–January 5, 2026) welcomes beginners. Register in advance and help track local bird populations.

Wishing you and yours a happy, safe and healthy holiday season!