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CA Plans for Individuals and Families - Forms and Brochures

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2016 – Covered California Materials


Covered California Sales Brochure

English 7.7MB   11/10/15

DigiMag version 0kB   12/31/69


Plan choices by location (IFP On and Off Exchange)

English 88kB   12/02/15


2016 HMO Plan Overviews
Download only

CommunityCare HMO Platinum 90

English 168kB   10/30/15


CommunityCare HMO Gold 80

English 166kB   10/30/15


CommunityCare HMO Silver 70

English 32kB   10/30/15


CommunityCare HMO Silver Cost-sharing Reduction Plan Overviews
Download only

CommunityCare HMO Silver 73

English 30kB   10/30/15


CommunityCare HMO Silver 87

English 30kB   10/30/15


CommunityCare HMO Silver 94

English 30kB   10/30/15


2016 PureCare HSP Plan Overviews
Download only

PureCare HSP Platinum 90

English 31kB   10/30/15


PureCare HSP Gold 80

English 28kB   10/30/15


PureCare HSP Silver 70

English 33kB   10/30/15


PureCare HSP Silver 73 (CSR)

English 30kB   12/17/15


PureCare HSP Silver 87 (CSR)

English 30kB   12/17/15


PureCare HSP Silver 94 (CSR)

English 31kB   12/17/15


PureCare HSP Bronze 60

English 32kB   10/30/15


PureCare HSP Minimum Coverage

English 31kB   10/30/15


2016 PureCare One EPO Plan Overviews

PureCare One EPO Platinum 90

English 25kB   10/30/15


PureCare One EPO Gold 80

English 23kB   10/30/15


PureCare One EPO Silver 70

English 26kB   10/30/15


PureCare One EPO Silver 73 (CSR)

English 24kB   10/30/15


PureCare One EPO Silver 87 (CSR)

English 24kB   10/30/15


PureCare One EPO Silver 94 (CSR)

English 25kB   10/30/15


PureCare One EPO Bronze 60

English 26kB   10/30/15


PureCare One EPO Minimum Coverage

English 26kB   10/30/15


2016 Disclosures

HMO and HSP Disclosure for Covered California

English 3.5MB   10/30/15

Español (Spanish) 3.2MB   10/30/15

Chinese (Chinese) 3.7MB   10/30/15


EPO Disclosure for Covered California

English 2.8MB   10/30/15

Español (Spanish) 2.8MB   10/30/15

Chinese (Chinese) 3.1MB   10/30/15


2016 – Materials and Forms


Plan choices by location (IFP On and Off Exchange)

English 88kB   12/02/15


Enrollment Applications

Individual & Family Plans HMO Enrollment Application

English 456kB   10/30/15

Español (Spanish) 434kB   10/30/15

Chinese (Chinese) 822kB   10/30/15

Effective January 1, 2016


Individual & Family Plans HSP Enrollment Application

English 3.1MB   10/30/15

Español (Spanish) 439kB   10/30/15

Chinese (Chinese) 815kB   10/30/15

Effective January 1, 2016


Individual & Family Plans PPO Enrollment Application

English 3.2MB   12/17/15

Spanish - Coming soon 1kB   11/10/15

Chinese - Coming soon 1kB   11/10/15

Effective January 1, 2016


Individual & Family Plans EPO Enrollment Application

English 3.1MB   12/17/15

Spanish - Coming soon 1kB   11/10/15

Chinese - Coming soon 1kB   11/10/15

Effective January 1, 2016


Hardship Exemption Form

English 178kB   01/21/16


Rate Guide

January 2016

English 1.7MB   12/01/15


Plan Overviews
Download only

HMO

Platinum 90 HMO 164kB   10/30/15

Gold 80 HMO 162kB   10/30/15

Silver 70 HMO 32kB   10/30/15


HSP

Platinum 90 HSP 31kB   10/30/15

Gold 80 HSP 28kB   10/30/15

Silver 70 HSP 31kB   10/30/15

Bronze 60 HSP 32kB   10/30/15

Minimum Coverage HSP 32kB   10/30/15


PPO

Platinum 90 PPO 25kB   10/30/15

Gold 80 PPO 23kB   10/30/15

Silver 70 PPO 26kB   10/30/15

Bronze 60 PPO 26kB   10/30/15

Minimum Coverage PPO 26kB   10/30/15


EPO

Platinum 90 EPO 26kB   10/30/15

Gold 80 EPO 24kB   10/30/15

Silver 70 EPO 26kB   10/30/15

Bronze 60 EPO 26kB   10/30/15

Minimum Coverage EPO 26kB   10/30/15

Download only


2016 Disclosures

EPO Disclosure

English 2.8MB   10/30/15

Spanish 2.8MB   12/02/15

Chinese 2.9MB   12/02/15


PPO Disclosure

English 164kB   10/30/15

Spanish 159kB   12/02/15

Chinese 292kB   12/02/15


HMO-HSP Disclosure

English 781kB   11/05/15

Spanish - Coming soon 1kB   11/10/15

Chinese - Coming soon 1kB   11/10/15


Dental and Vision

Adult Dental and Vision Coverage with HMO and HSP Health Plans

English 165kB   11/05/15

Download only


Adult Dental and Vision Coverage with PPO and EPO Health Plans

English 317kB   11/05/15

Download only


2016 – Sample Coverage Documents

Sample Evidences of Coverage and Certificates

IFP On Exchange EPO

English 3.5MB   12/10/15


IFP On Exchange HMO

English 3.4MB   12/10/15


IFP On Exchange HSP

English 3.5MB   12/10/15


IFP Off Exchange EPO

English 3.2MB   12/10/15


IFP Off Exchange HMO

English 3.2MB   12/10/15


IFP Off Exchange HSP

English 3.3MB   12/10/15


IFP Off Exchange PPO

English 3.3MB   12/10/15


2015 – Covered California Plan Materials and Forms


Covered California Sales Brochure

English 6.7MB   12/15/14

DigiMag version 0kB   12/31/69

Download only


2015 HMO Plan Overviews for Covered California
Download only

CommunityCare HMO Platinum 90

English 153kB   01/09/15


CommunityCare HMO Gold 80

English 151kB   01/09/15


CommunityCare HMO Silver 70

English 157kB   01/09/15


CommunityCare HMO Silver Cost-sharing Reduction Plan Overviews for Covered California
Download only

CommunityCare HMO Silver 73

English 154kB   01/09/15


CommunityCare HMO Silver 87

English 157kB   01/09/15


CommunityCare HMO Silver 94

English 155kB   01/09/15


2015 PureCare HSP Plan Overviews for Covered California
Download only

PureCare HSP Bronze 60

English 156kB   01/09/15


PureCare HSP Minimum Coverage

English 180kB   02/11/15


2015 PureCare One EPO Plan Overviews for Covered California
Download only

PureCare One EPO Platinum 90

English 145kB   01/09/15


PureCare One EPO Gold 80

English 143kB   01/09/15


PureCare One EPO Silver 70

English 143kB   01/09/15


PureCare One EPO Bronze 60

English 143kB   01/09/15


PureCare One EPO Minimum Coverage

English 143kB   01/09/15


PureCare One EPO Cost-sharing Reduction Plan Overviews for Covered California

PureCare One EPO Silver 73 (CSR)

English 150kB   01/09/15


PureCare One EPO Silver 87 (CSR)

English 150kB   01/09/15


PureCare One EPO Silver 94 (CSR)

English 151kB   01/09/15


2015 Disclosures for Covered California

HMO and HSP Disclosure for Covered California

English 3MB   12/03/14

Download only


EPO Disclosure for Covered California

English 2.8MB   12/03/14


Evidence of Coverage for CommunityCare HMO Covered California Plans
Download only

HMO Platinum 90 Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Platinum 90 (AI-AN) Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Gold 80 Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Gold 80 (AI-AN) Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Silver 70 Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Silver 70 (AI-AN) Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Silver 94 Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HMO Silver 87 Evidence of Coverage (EOC)

English 1.4MB   12/04/14


HMO Silver 73 Evidence of Coverage (EOC)

English 1.5MB   12/04/14


Covered California Policies for EPO PureCare One Plans
Download only

EPO Platinum 90 Plan Policy

English 1.5MB   12/04/14


EPO Gold 80 Plan Policy

English 1.5MB   12/04/14


EPO Silver 70 Plan Policy

English 1.5MB   12/04/14


EPO Silver 94 Plan Policy

English 1.5MB   12/04/14


EPO Silver 87 Plan Policy

English 1.5MB   12/04/14


EPO Silver 73 Plan Policy

English 1.5MB   12/04/14


EPO Bronze 60 Plan Policy

English 1.5MB   12/04/14


EPO Bronze 60 (AI-AN) Plan Policy

English 1.5MB   12/04/14


EPO Minimum Coverage Plan Policy

English 1.5MB   12/04/14


Covered California Evidence of Coverage for HSP PureCare Plans
Download only

HSP Bronze 60 Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HSP Bronze 60 (AI-AN) Evidence of Coverage (EOC)

English 1.5MB   12/04/14


HSP Minimum Coverage Evidence of Coverage (EOC)

English 1.5MB   12/04/14


2015 – Plan Materials and Forms

Enrollment Applications (off Marketplace)

Individual & Family Plans HMO/HSP Enrollment Application

English 3.2MB   12/04/14


Individual & Family Plans PPO Enrollment Application

English 3.1MB   12/04/14


Individual & Family Plans EPO Enrollment Application

English 3.2MB   12/04/14


Rates (off Marketplace)

Individual & Family Plans Northern California Rate Guide

English 1.5MB   01/06/15


Individual & Family Plans Southern California Rate Guide

English 1.8MB   01/06/15



CA Essential Rx Drug List

English 709kB   01/04/16


HMO Plan Overviews (off Marketplace)

Platinum 90 HMO

English 161kB   01/09/15


Gold 80 HMO

English 159kB   01/09/15


Silver 70 HMO

English 165kB   01/09/15


HSP Plan Overviews (off Marketplace)

Platinum 90 HSP

English 255kB   02/11/15


Gold 80 HSP

English 196kB   02/11/15


Silver 70 HSP

English 80kB   02/11/15


Bronze 60 HSP

English 164kB   01/09/15


Minimum Coverage HSP

English 163kB   01/09/15


PPO Plan Overviews (off Marketplace)

Platinum 90 PPO

English 145kB   01/09/15


Gold 80 PPO

English 145kB   01/09/15


Silver 70 PPO

English 148kB   01/09/15


Bronze 60 PPO

English 25kB   04/15/15


Minimum Coverage PPO

English 26kB   02/11/15


EPO Plan Overviews (off Marketplace)

Platinum 90 EPO

English 162kB   01/09/15


Gold 80 EPO

English 160kB   01/09/15


Silver 70 EPO

English 202kB   02/11/15


Bronze 60 EPO

English 160kB   01/09/15


Minimum Coverage EPO

English 160kB   01/09/15


Policies for EPO PureCare One Plans (off Marketplace)
Download only

Platinum 90 EPO Policy

English 1.5MB   01/05/15


Gold 80 EPO Policy

English 1.5MB   01/05/15


Silver 70 EPO Policy

English 1.5MB   01/05/15


Bronze 60 EPO Policy

English 1.5MB   01/05/15


Minimum Coverage EPO Policy

English 1.5MB   01/05/15


Policies for PPO Plans (off Marketplace)
Download only

Platinum 90 PPO Policy

English 811kB   01/05/15


Gold 80 PPO Policy

English 811kB   01/05/15


Silver 70 PPO Policy

English 815kB   01/05/15


Bronze 60 PPO Policy

English 814kB   01/05/15


Minimum Coverage PPO Policy

English 814kB   01/05/15


Drug List


CA Essential Rx Drug List

English 709kB   01/04/16


HIPAA Forms


Compliance Forms
HIPAA Authorization forms required for requesting applicant and member medical records

Authorization for Disclosure of Protected Health Information

English 575kB   04/16/13

Español (Spanish) 586kB   04/16/13

Chinese (Chinese) 487kB   04/16/13

Download Only


Glossary of Health Coverage and Medical Terms


Glossary of Health Coverage and Medical Terms

English 92kB   09/11/12

Español (Spanish) 357kB   08/28/13

Chinese (Chinese) 231kB   08/28/13

Navajo 409kB   08/28/13

Health insurance companies and group health plans are required to make available a uniform glossary of health coverage and medical terms commonly used in plan documents. The Uniform Glossary is meant to help the consumer understand some of the most common language used in health insurance documents. Please log in to request a hardcopy of the document by mail.



Information last updated 12-10-2015

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Disclaimer

You are now leaving Health Net's website for Medicare.gov. While Health Net believes you may find value in reading the contents of this site, Health Net does not endorse, control or take responsibility for this organization, its views or the accuracy of the information contained on the destination server.

To proceed to Medicare.gov, click 'Continue'. To stay on the Health Net website, click 'Cancel'.

If you would prefer to speak to a Health Net representative about this issue, please click here to go to our Customer Service Center page.


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Important Notice

General Purpose
Health Net's National Medical Policies (the "Policies") are developed to assist Health Net in administering plan benefits and determining whether a particular procedure, drug, service, or supply is medically necessary. The Policies are based upon a review of the available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the drug or device, evidence-based guidelines of governmental bodies, and evidence-based guidelines and positions of select national health professional organizations. Coverage determinations are made on a case-by-case basis and are subject to all of the terms, conditions, limitations, and exclusions of the Member's contract, including medical necessity requirements. Health Net may use the Policies to determine whether, under the facts and circumstances of a particular case, the proposed procedure, drug, service, or supply is medically necessary. The conclusion that a procedure, drug, service, or supply is medically necessary does not constitute coverage. The Member's contract defines which procedure, drug, service, or supply is covered, excluded, limited, or subject to dollar caps. The policy provides for clearly written, reasonable and current criteria that have been approved by Health Net's National Medical Advisory Council (MAC). The clinical criteria and medical policies provide guidelines for determining the medical necessity criteria for specific procedures, equipment and services. In order to be eligible, all services must be medically necessary and otherwise defined in the Member's benefits contract as described in this "Important Notice" disclaimer. In all cases, final benefit determinations are based on the applicable contract language. To the extent there are any conflicts between medical policy guidelines and applicable contract language, the contract language prevails. Medical policy is not intended to override the policy that defines the Member's benefits, nor is it intended to dictate to providers how to practice medicine.


Policy Effective Date and Defined Terms.
The date of posting is not the effective date of the Policy. The Policy is effective as of the date determined by Health Net. All policies are subject to applicable legal and regulatory mandates and requirements for prior notification. If there is a discrepancy between the policy effective date and legal mandates and regulatory requirements, the requirements of law and regulation shall govern. In some states, prior notice or posting on the website is required before a policy is deemed effective. For information regarding the effective dates of Policies, contact your provider representative. The Policies do not include definitions. All terms are defined by Health Net. For information regarding the definitions of terms used in the Policies, contact your provider representative.


Policy Amendment without Notice.
Health Net reserves the right to amend the Policies without notice to providers or Members. In some states, prior notice or website posting is required before an amendment is deemed effective.


No Medical Advice.
The Policies do not constitute medical advice. Health Net does not provide or recommend treatment to Members. Members should consult with their treating physician in connection with diagnosis and treatment decisions.


No Authorization or Guarantee of Coverage.
The Policies do not constitute authorization or guarantee of coverage of any particular procedure, drug, service, or supply. Members and providers should refer to the Member contract to determine if exclusions, limitations and dollar caps apply to a particular procedure, drug, service, or supply.


Policy Limitation: Member's Contract Controls Coverage Determinations.
Statutory Notice to Members: The materials provided to you are guidelines used by this plan to authorize, modify or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract. The determination of coverage for a particular procedure, drug, service, or supply is not based upon the Policies, but rather is subject to the facts of the individual clinical case, terms and conditions of the Member's contract, and requirements of applicable laws and regulations. The contract language contains specific terms and conditions, including pre-existing conditions, limitations, exclusions, benefit maximums, eligibility, and other relevant terms and conditions of coverage. In the event the Member's contract (also known as the benefit contract, coverage document, or evidence of coverage) conflicts with the Policies, the Member's contract shall govern. The Policies do not replace or amend the Member contract.


Policy Limitation: Legal and Regulatory Mandates and Requirements
The determinations of coverage for a particular procedure, drug, service, or supply is subject to applicable legal and regulatory mandates and requirements. If there is a discrepancy between the Policies and legal mandates and regulatory requirements, the requirements of law and regulation shall govern.


Reconstructive Surgery
California Health and Safety Code 1367.63 requires health care service plans to cover reconstructive surgery. "Reconstructive surgery" means surgery performed to correct or repair abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following:


1. To improve function; or
2. To create a normal appearance, to the extent possible.


Reconstructive surgery does not mean "cosmetic surgery," which is surgery performed to alter or reshape normal structures of the body in order to improve appearance.


Requests for reconstructive surgery may be denied, if the proposed procedure offers only a minimal improvement in the appearance of the enrollee, in accordance with the standard of care as practiced by physicians specializing in reconstructive surgery.


Reconstructive Surgery after Mastectomy
California Health and Safety Code 1367.6 requires treatment for breast cancer to cover prosthetic devices or reconstructive surgery to restore and achieve symmetry for the patient incident to a mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the copayment, or deductible and coinsurance conditions, that are applicable to the mastectomy and all other terms and conditions applicable to other benefits. "Mastectomy" means the removal of all or part of the breast for medically necessary reasons, as determined by a licensed physician and surgeon.


Policy Limitations: Medicare and Medicaid
Policies specifically developed to assist Health Net in administering Medicare or Medicaid plan benefits and determining coverage for a particular procedure, drug, service, or supply for Medicare or Medicaid Members shall not be construed to apply to any other Health Net plans and Members. The Policies shall not be interpreted to limit the benefits afforded Medicare and Medicaid Members by law and regulation.

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You are now leaving HealthNet.com

Health Net of Arizona, Inc.
CommunityCare HMO


The predictability of our HMO plans with the flexibility to see in-network specialists without a referral for certain professional services. Available for small businesses in Maricopa, Pima and Pinal counties.


HSA-compatible plans offer advantages of coverage with the tax-savings potential of a health savings account. It's one way to take more control over your health care dollars.

Health Net of Arizona, Inc.
CommunityCare HMO


The predictability of our HMO plans with the flexibility to see in-network specialists without a referral for certain professional services.


HSA-compatible plans offer advantages of coverage with the tax-savings potential of a health savings account. It's one way to take more control over your health care dollars.

Health Net of Arizona, Inc.
HMO Statewide


The predictability of our HMO plans with the flexibility to see in-network specialists without a referral for certain professional services.

Health Net
Life Insurance Company
PPO


Competitively priced, Health Net Life Insurance Company's PPO insurance plans are a perfect fit for groups that want to offer their employees choice and flexibility. Employees can go directly to our broad PPO network of doctors and hospitals. Or they can see a doctor and use covered services outside the network. Out-of-pocket costs are generally lower when using the PPO network.


HSA-compatible plans offer advantages of coverage with the tax-savings potential of a health savings account. It’s one way to take more control over your health care dollars.

PPO

Competitively priced, Health Net Life Insurance Company’s PPO insurance plans are a perfect fit for groups that want to offer their employees choice and flexibility. Employees can go directly to our broad PPO network of doctors and hospitals. Or they can see a doctor and use covered services outside the network. Out-of-pocket costs are generally lower when using the PPO network.

PureCare One EPO

Exclusive Provider Organization (EPO) insurance plans from Health Net Life Insurance Company bring together HMO and PPO elements. Like an HMO, these plans come with a set provider network – the PureCare One EPO network. There is no coverage for services received outside of the network, except for urgent or emergency care, or for services authorized by Health Net. What’s different is that there is no requirement to have a primary care physician. Members may self-refer to any in-network provider.

SmartCare HMO

Health Net of California, Inc.'s SmartCare HMO plans connect members to a tailored network of provider groups and hospitals near where they live or work. Adding convenience, SmartCare includes access to CVS MinuteClinics for walk-in medical services and preventive care. Available in Los Angeles, Orange, Riverside, San Bernardino, San Diego, Santa Clara and Santa Cruz Counties.

WholeCare HMO

Health Net of California, Inc.’s WholeCare HMO plans come with our largest tailored network – delivering access and affordability for employers and employees alike. Available in 30 counties statewide, WholeCare HMO plans also feature CVS MinuteClinics for walk-in medical services and preventive care.

Salud HMO y Más

Health Net of California, Inc.'s Salud HMO y Más plans are designed to fit California's fast-growing Latino market offering cost-savings for employers (over comparable HMO plans) and predictable copayments for employees. Members enrolled in these plans use the Salud HMO y Más network in California or may self-refer to a participating provider in Health Net's Mexico service area for covered services. Salud HMO y Más plans also feature CVS MinuteClinics for walk-in medical services and preventive care.

PureCare HSP

Health Net of California, Inc.'s PureCare HSPs (health care services plan) work much like an HMO in that members are required to have a primary care physician. What’s different is that HSP members have the flexibility to self-refer to doctors and hospitals in the PureCare HSP network. There is no coverage for out-of-network services, except for urgent or emergency care, or services authorized by Health Net.

Full Network

We've brought our popular Full Network HMO back. It pairs with any of our Gold or Platinum HMO plans in nearly all California counties! These Full Network HMO plans come with our 30 county statewide HMO network. Full Network HMO plans also feature CVS MinuteClinics for walk-in medical services and preventive care.

CommunityCare

We're introducing a pair of CommunityCare Silver and Gold level plans for employers in Los Angeles and Orange counties. These HMO designs come with our locally based CommunityCare network and the convenience of CVS MinuteClinics for walk-in medical services and preventive care.

CommunityCare

Health Net Health Plan of Oregon, Inc. (Health Net) CommunityCare plans are available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.


Our base plan, featuring the familiar single-tier benefit structure and access to the select Health Net CommunityCare network, is the most affordable CommunityCare option.

CommunityCare Choice Plus

Health Net Health Plan of Oregon, Inc. (Health Net) CommunityCare Choice Plus plans are available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.


Choice Plus gives members three levels of access and coverage. They can use the CommunityCare network, other Health Net contracted providers, or a non-network provider. Services received via the CommunityCare network are covered at a higher, in-network benefit while out-of-network services are reimbursed at a percentage of the maximum allowable amount.


CommunityCare 3T

Health Net Health Plan of Oregon, Inc. (Health Net) CommunityCare 3T plans are available to Oregon groups located in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.


CommunityCare 3T gives members three levels of access and coverage. They can use the CommunityCare network, other Health Net contracted providers, or a non-network provider. Services received via the CommunityCare network are covered at a higher, in-network benefit while out-of-network services are reimbursed at a percentage of the maximum allowable amount.


Standard Plans

Health Net Health Plan of Oregon, Inc. (Health Net) Standard plans are available to Oregon groups statewide. The benefit design of these plans match those designated by the State of Oregon. Pediatric vision coverage is included. Pediatric dental coverage is not available with these plans.

PPO

Health Net Health Plan of Oregon, Inc. (Health Net) Preferred Provider Organization (PPO) plans are available to Oregon groups statewide. Our PPO plans feature our widest range of deductible options to fit a variety of budgets.

PPO

Health Net Health Plan of Oregon, Inc. (Health Net) Preferred Provider Organization (PPO) plans are available to Washington groups statewide, and are a perfect fit for groups that want to offer their employees choice and flexibility. They have full access to PPO doctors and hospitals in the First Choice network. Or they can see a doctor and use services outside the network for a higher out-of-pocket cost.

Contact Enrollment Services

Enrolling is easy. Contact your regional Health Net representative using the number below
and we'll help you with the rest.


Here is the contact information for:

91367, LOS ANGELES
Click here to change location.

Medi-Cal: 1-800-327-0502

CalViva: 1-888-893-1569

Dental: 1-800-213-6991

TTY/TTD: 711

Contact Enrollment Services

Joining is easy. Call Health Net using the number below and we will help you with the rest.


Here is the contact information for:

91367, LOS ANGELES
Click here to change location.

Dental: 1-800-213-6991

Where You Can Buy Plans

You can buy health coverage directly from Health Net. We are also a part of Covered California® so you can buy a Health Net plan through the marketplace.


You have to buy health coverage through Covered California to get financial help from the government. You can click our link below to see if you qualify. Then Health Net can help you sign-up.

About Plan Years

Health plan choices may change from year-to-year. There may be new plan choices. Or changes in costs and benefits. Choose the year that matches when you want coverage to start. For example, click 2017 if you are looking at choices for next year. Have a special enrollment period for this year? Then click 2016. Note that the first effective date for our 2017 plans is January 1, 2017.

About Plan Levels

Health plans for individuals and families come in four metal levels: platinum, gold, silver and bronze. The difference between the levels is how much you pay versus how much the health insurance company pays.

There is also a minimum coverage option for people under 30. It’s also for people having financial hardship.

Health Net offers plans in all metal levels. So we have an option for you no matter what level of coverage you want.

About Plan Types

We offer several types of plans. There are HMO and HSP plans offered by Health Net of California, Inc. PPO and EPO insurance plans are offered by Health Net Life Insurance Company.

With an HMO, you have one main doctor called a primary care physician who coordinates all your care. You see your PCP for checkups, advice and care when sick or hurt. Your doctor refers you to other services when you need them. You get all services from the HMO network. There is no coverage if you see doctors who are not in the network, except in an emergency.

EPO insurance plans also come with a network of doctors and hospitals. You do not need a referral to use covered services but you do have to use the EPO network. There is no coverage if you see doctors who are not in the network, except in an emergency.

An HSP (Health care service plan) has one network to use for all covered services. There is no coverage for services received outside of the network, except in an emergency or for urgent care. With an HSP, you are required to pick a primary care physician (PCP)– a main doctor to see for checkups, advice and care when sick or hurt. Members can go directly to any doctor or specialist in the network without the need for a referral.

PPO plans give you the choice to go directly to any doctor. You can see a doctor in the PPO provider network. Or you can visit a doctor outside our network. You generally pay less out-of-pocket when you go to a doctor that is in the PPO network.

You have a PCP PCP referral needed before you get services Have one network for all services OK to get services outside of the network
HMO Yes Yes Yes, CommunityCare No, except as noted above.
EPO No No Yes, PureCare One No, except as noted above.
HSP Yes No Yes, PureCare No, except as noted above.
PPO No No No. Using the PPO network is your choice. When you do, you generally pay less out-of-pocket! Yes

About Financial Help

You can buy health coverage directly from Health Net. We are also a part of Covered California® so you can buy a Health Net plan through the marketplace.

You have to buy health coverage through Covered California to get financial help from the government. You can click our link below to see if you qualify. Then Health Net can help you sign-up.

About Pediatric Dental

Special Needs Plan Disclaimer

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