You can see providers outside of the network, but you may pay more. You want your PCP to coordinate and oversee your care.Ī PPO is also a type of health coverage with a set network of health care providers.In Arizona, HMO members are not required to select a PCP and may access an in-network specialist without a PCP referral. Your PCP will arrange your care and refer you to specialists in the network as needed. You get care and choose a primary care physician (PCP) from your network. A network is a set group of doctors, hospitals, clinics, labs, and pharmacies. If enrollment of the additional dependent is in a higher premium bracket, an additional premium amount is required.Īn HMO is a type of health coverage that offers health care services through a network of health care providers. Coverage will not begin until application and premium are received within 31 days after birth or placement. To continue coverage beyond this initial period, a child must be enrolled within 31 days of birth or placement. *In general, an eligible newborn child (or newly adopted child, or child in foster care) is covered for 31 days from his or her date of birth. If you or your spouse is eligible for Medicare, learn more or apply online for a Health Net Medicare Advantage or Medicare Supplement plan. Medicare Advantage and Medicare Supplement plans are individual plans. If you are enrolled in an employer sponsored plan, please contact the employer's benefits department for instructions and an enrollment change form, otherwise please contact Health Net Member Services at the number on your ID card. Please note: You must submit with proper documentation to Health Net. Newly eligible/ineligible for advance payment of the premium tax credit or change in eligibility for cost-sharing reductions.Violation of material provision of plan contract.
Loss of coverage by a subscriber's spouse.The birth, adoption or placement for adoption or foster care of a child*.Death of a subscriber's spouse or dependent.In addition, we will generally accept enrollments for newly eligible members within 60 days after the following events: If you are enrolled in a Health Net Individual or Family plan through Covered California or your state's Health Insurance Marketplace, you may add or delete enrolled family members during your open enrollment period. You may register and log in to the Member site beginning on the effective date of your plan and continue using the Member site for 18 months after your coverage ends.To log in or register for the Member site, you must be the primary subscriber or a dependent on a Health Net policy, or be the parent or guardian of a minor who is the primary subscriber on a Health Net plan.You may use the Member site for 18 months after your coverage ends.However, some site features are hidden until your plan is in effect. You may register and log in to the Member site once your initial payment has been processed.To log in or register for the Member site, you must be the primary subscriber or a dependent on a Health Net plan, or be the parent or guardian of a minor who is the primary subscriber on a Health Net plan.You must be 12 years or older to use this site.If you enrolled in a Health Net plan through a state or federal health care marketplace such as Covered California™ or the Health Insurance Marketplace in Arizona: If you can't find this information, please contact us. To view your Coverage Document on you must be registered with our website. Your Coverage Document will provide detailed information regarding your plan benefits. It may cost you more to go out-of-network. In a PPO plan, you can use doctors, hospitals and other health care providers that belong to your plan's network, or you can get care from an out-of-network Medicare provider. If you get routine care from out-of-network providers, neither Medicare nor Health Net will pay for the costs. In most HMO plans, members can only go to doctors, other health care providers or hospitals in the plan's network, except for: Going outside of your plan's network may cost you more. With a PPO, you have the option of getting services "in" or "out" of your plan's network.If you are admitted to a hospital because of an injury or life-threatening medical emergency, you (or someone acting for you) should notify your PCP as soon as reasonably possible. In a medical emergency, go straight to the nearest hospital – It does not have to be in your plan's provider network.You are only covered for health care services you get from inside the provider network.HMO, EPO and Health service plan (HSP) members:
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