Health Net
For 2017, Health Net is offering a variety of health plans throughout California. There are EPOs, HSPs, HMOs, and PPOs plans. Some of the plans are offered through Covered California and some, like the PPO plans, are only offered off-exchange direct from Health Net.
Health Net Multiple 2017 California Health Plans
Health Net offers both an EPO (Exclusive Provider Organization) and a HSP (Healthcare Service Plan). They are essentially the same type of health plan. The HSP requires a member to list a Primary Care Physician like an HMO. For the EPO, the PCP designation was optional until 2017. More important to Health Net is that the HSP products are listed and regulated by the Department of Managed Health Care, while the EPOs are regulated by the California Department of Insurance, according to Health Net.
For HSP and EPO plans you can visit any doctor in the network. There is no out-of-network coverage like a PPO plan. With the HMO plans you can visit your Primary Care Physician and get a referral to a specialist within the Medical Group. To see which what doctor are in-network you can visit the Health Net Provider Search Tool.
All of the health plans conform to the standard benefit design for in-network coverage as specific by Covered California for qualifying health plans. Off-exchange plans don’t qualify for the ACA tax credits. Services obtained from a Non-Preferred or Preferred provider outside of California through the First Health Network will no longer be covered. Only out-of-state urgent care and emergency services will be treated as in-network provider cost shares.
The Enhanced Silver plans with reduced member cost sharing are only available through Covered California and subject to the household’s income.
Health Net plan locator shows which plans are available in which regions of California both through Covered California and off-exchange.
EPO Plan Summary of Benefits
2017 Bronze EPO Offx (0.5 MiB)
2017 EPO Disclosures (0.6 MiB)
2017 Gold EPO Offx (0.5 MiB)
2017 Minimum Coverage EPO Offx (0.5 MiB)
2017 Platinum EPO Offx (0.5 MiB)
2017 Silver EPO Offx (0.5 MiB)
HMO Plan Summary of Benefits
2017 Gold HMO Off (0.5 MiB)
2017 Platinum HMO Off (0.5 MiB)
2017 Silver HMO Off (0.5 MiB)
HSP Plan Summary of Benefits
2017 Bronze HSP Off (0.5 MiB)
2017 Gold HSP Off (0.5 MiB)
2017 Minimum Coverage Off (0.5 MiB)
2017 Platinum HSP Off (0.5 MiB)
2017 Silver HSP Off (0.5 MiB)
PPO Plan Summary of Benefits
2017 PPO Bronze Off Ex (0.5 MiB)
2017 PPO Disclosure (3.3 MiB)
2017 PPO Gold Off Ex (0.5 MiB)
2017 PPO Min Coverage Off Ex (0.5 MiB)
2017 PPO Platinum Off Ex (0.5 MiB)
2017 PPO Silver OFF Ex (0.5 MiB)
To get additional information on rates, paper applications, and information on Health Net’s dental and vision plans please visit http://insuremekevin.com/individual-and-family-navigation/health-net-california/
