Health Net individual and family health insurance. Health Net offers a variety of healthcare plans to meet the individual needs of its consumers. HMO, PPO, and POS plans are available in 27 different states nationwide. Health Net has found plans that fit the budgets and healthcare needs for approximately 6.5 million individual members.
All female Health Net members can self-refer, within their Participating Physician Group, for Obstetrical and Gynecological (OB/GYN) services. For other referrals, your Primary Care Physician will determine if an office visit is necessary. Generally, Primary Care Physicians refer exclusively to specialist physicians who are Participating Providers within their common Participating Physician Group.
After you become eligible with Health Net, you must call your Primary Care Physician before making any future appointments with the specialist. All specialty care requires a referral from the Primary Care Physician/physician group, and they arrange for the coordination of any future services.
To request an authorization for a second opinion, contact Health Net Member Services at 1-800-522-0088. Health Net will review the request in accordance with Health Net’s second opinion policy. For more detailed information see Section 3 of your FEHB brochure.
Health Net members do not need a referral to receive chiropractic care from a chiropractor participating in the American Specialty Health Plan (ASH) network. For the most current listing of participating chiropractors go to Americanspecialtyhp.com or call the ASH Member Services Department at 1-800-678-9133.
Yes. Through our Decision Power program, all members have access to Health Coaches who are specially trained health professionals and can provide unbiased, evidence-based health information and coaching support. They help members carefully consider the potential risks, benefits and outcomes of treatment options so they can better evaluate available health care choices.
Health Coaches are available 24 hours a day, 7 days a week. Health Coaches can be reached via telephone or online by logging in to www.healthnet.com > Decision Power Health & Wellness.
Members must always contact their Participating Physician Group and/or member’s Primary Care Physician as soon as possible whenever emergency services have been received. After the member’s medical problem ceases to be an emergency, follow-up care must be performed or authorized by the member’s physician group or it will not be covered (see Section 5 (d) of your FEHB brochure).
Health Net defines an emergency as a sudden injury or illness which could threaten life, limb, or internal organs. Urgently needed care is defined as immediate treatment for a sudden injury or illness that is required to prevent serious health deterioration. For a more detailed description of emergency services please see Section 5 (d) of your FEHB brochure.
