Coverage Provided By Your Employer
Primary Exclusive Provider Organization (EPO)
What are the Basics?
The Primary EPO plan serves members in the counties listed below. You can choose a Primary Care Physician from our EPO network. That Primary Care Physician oversees all of your health care and provides referrals and authorizations whenever specialty care is needed.
San Luis Obispo
How Does it Work?
- Call your physician group and make an appointment to see your Primary Care Physician.
- Women can self-refer directly to an EPO network OB/GYN at any time without Primary Care Physician authorization.
- Your copayment for office visits, emergency room visits, hospitalization and prescriptions depend on the HMO plan your employer chooses.
- You'll know your copayment amounts in advance - there are no surprises.
- There's no paperwork either; you won't have to submit claims for reimbursement.
- For services not available through your physician group, talk to your Primary Care Physician; he or she must authorize all referrals to specialists in the EPO network.
What are my Benefits?
- Health Net's Primary EPO plan offers basic, inpatient and emergency services.
- The EPO plan covers preventive care and health education.
- Emergency care is covered worldwide.
- Copayment amounts and specified services offered will differ according to the plan(s) selected by your employer. See your employer's benefits representative to find out which plan(s) are available to you.
The following benefits are provided to Primary EPO members:
- Office visits
- Hospitalization coverage
- X-ray and laboratory procedures
- Vision and hearing examinations
- Prenatal, postnatal and newborn care office visits
- Outpatient mental health consultation and treatment