Health Maintenance Organization
With Health Maintenance Organization (HMO) plans, members choose a primary care physician (PCP) from our network of providers and pay a fixed monthly fee. Their PCP will then oversee all health care related services, including referrals and authorizations. HMOs are ideal for employees who would like one doctor to coordinate all their medical care at predictable costs.
If you select an HMO plan, your employees can depend on basic, inpatient, and emergency services. Many plans include office visits, hospitalization, X-ray and lab services, prenatal and postnatal services, mental health services and more. Copays may vary according to plan.
- Basic, inpatient and emergency services
- Preventive care
- X-Ray and Lab Procedures
- Prenatal, postnatal and newborn care office visits
- Mental health services
Full Network HMO plans
Health Net HMO Plans
We know HMOs! Health Net has a variety of plan designs for businesses of all sizes. Our Full Network HMO gives you and your employees access to thousands of physicians and pharmacies across the state.
If you select an HMO plan, your employees can depend on basic, inpatient, and emergency services. Many plans include office visits, hospitalization, X-ray and lab services, prenatal and postnatal services, mental health services and more. Copays vary according to plan.
Elect Open Access (EOA) Plans
Elect Open Access (EOA) is an HMO plan with set copays, unlimited lifetime benefits, and a primary doctor to coordinate all of your care. However, an EOA also offers the flexibility of seeing any provider within Health Net's PPO provider network without needing a referral. For this added convenience, members who visit a PPO provider will have slightly higher copays per visit.
EOA products are also available with our ExcelCare Network, a subset of our full HMO network (see Tailored Network HMO plans below), available in Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco, Santa Clara, Stanislaus and Ventura counties. For more information on EOA plans, call your broker or Health Net representative.
Point-of-Service (POS) Plans
A POS plan combines aspects from both HMO and PPO plans, offering more freedom than a traditional HMO. Members choose a primary care physician from our network of providers, but our POS also offers limited coverage for members who choose to see an out-of-network provider.
Health Net POS is a two-tiered point-of-service plan. Members have the option to use benefits at an HMO benefit level or PPO benefit level whenever they need care. HMO benefits include primary care physician, referral to see a specialist, predictable payments and no claim paperwork. PPO benefits include the option to see any doctor or specialist in the Health Net network without a referral, payment of deductible and coinsurance and possibly filing claim forms.
CONTACT A REPRESENTATIVE TO GET A QUOTE
- Tailored Network HMO plans
SmartCare offers a streamlined collection of HMO options to give you meaningful plan choices that are easy to understand, compare and select.
Health Net SmartCare puts together all the pieces you and your employees value, so you can offer them a single solution that works today and tomorrow. Now you and your employees can prosper with:
- Simple, more flexible plan choices that meet budgets and exceed expectations.
- A popular and proven network expanded for greater access and value.
- Whole person health - benefits that make employees feel valued, support their well-being and sustain productivity.
Learn more about SmartCare
Health Net's ExcelCare Network combines all the best benefits from our HMO and Elect Open Access (EOA) plan with a select network of affordable providers. The ExcelCare Network was designed to be a cost-effective health plan that offers quality coverage.
Learn more about ExcelCare Network plans
This affordable HMO subset plan gives your group members access to Sutter Health's large provider network. Available in select California counties.
Learn more about PremierCare Network plans
Salud con Health Net
Salud con Health Net is a system of health care designed to specifically address the cultural preferences of the Hispanic community. Members enjoy a health care experience that's affordable, local and culturally competent.
Salud plans make it possible to get what's really important when it comes to benefits - comprehensive coverage, plan choice and low, predictable copays. Plan members and insureds also have access to participating SIMNSA1 providers in Mexico.
Learn more about Salud plans