Health Net CommunityCare HMO Open Access Platinum $20/$40/$2000. Health Insurance Plan

Health Net CommunityCare HMO Open Access Platinum $20/$40/$2000.

Health Net HMO


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Cost & Ratings For

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U.S. News Rating
Monthly Premium *
Annual Deductible
Out-of-Pocket Limit
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U.S. News Ratings

For Individuals

For Families

How We Rated Plans

General Costs & Benefits

Monthly Premium

Moderate
*

Individual

Moderate
*

Family

Applicants Charged More Than Quoted Premium

0%

Applicants Denied Enrollment

0%

Deductible

$0

Individual

$0

Family

Out-of-Pocket Limit

$2,000

Individual

$4,000

Family

What's Included in Out-of-Pocket Limit

Coinsurance + Co-pay

Maximum Annual Benefits Paid

$0

Individual

$0

Family

Plan Type

Click here for a list of providers in network.

HMO

HSA Eligible

Yes

Office Visits

Preventive Care (Checkups, Screenings, Immunizations, etc.)

No Charge

Primary Care Visit for Illness or Injury

$20 Copay

To See a Doctor

$20 Copay

To See a Nurse, Physician's Assistant or Other Provider

Specialist Visit

$40 Copay

Prescription Drugs

Generics

$10 Copay

Brand-Name Drugs on Plan's Preferred List

See drug formulary as given by provider.

$20 Copay

Brand-Name Drugs Not on Plan's Preferred List

$50 Copay

Specialty Drugs (for Specific Complex or Chronic Conditions)

20% Coinsurance

Hospital Care

Inpatient Care

$500 Copay

Hospital Charges

No Charge

Physician Charges

Outpatient Surgery

20% Coinsurance

Hospital Charges

No Charge

Surgeon Charges

Emergency Care

Emergency Room

$150 Copay

Ambulance Service

No Charge

Urgent Care

$50 Copay

Tests

Diagnostic X-Rays and Lab Tests

No Charge

CT Scans, MRI, Other Advanced Imaging

$250 Copay

Maternity Care

Prenatal and Postnatal Care

$20 Copay

Labor and Delivery

$500 Copay

Child-Related Services

Dental Checkups

Not Covered

Eye Exams

No Charge

Glasses or Contacts

No Charge

Family Coverage for Partner

Same sex coverage

Yes

Domestic partner coverage

Yes

Rehabilitation & Quality of Life Services

Inpatient Rehabilitation

$500 Copay

Outpatient Rehabilitation

$40 Copay

Durable Medical Equipment (for Example, Wheelchairs)

20% Coinsurance

Habilitation Services (for Patients with Specials Needs)

$40 Copay

Home Healthcare (Other than Nursing)

No Charge

Private Nursing (in the Home)

Not Covered

Short-Term Skilled Nursing Care (in a Licensed Facility)

$500 Copay

Alcohol & Drug Abuse Services

Inpatient Care

$500 Copay

Outpatient Care

$20 Copay

Mental Health Services

Inpatient Care

$500 Copay

Outpatient Care

$20 Copay

Long Term Care & End-of-Life Services

Long-Term Care in Nursing Home

Not Covered

Hospice Care

$500 Copay

Other Services

Acupuncture

Not Covered

Chiropractor

Covered with Limitations

Cosmetic Surgery

Covered with Limitations

Dental Checkups (Adult)

Not Covered

Eye Exams (Adult)

Covered

Foot Care (Routine)

Covered with Limitations

Hearing Aids

Covered

Hearing Test

Covered

Infertility Treatment

Not Covered

Nonemergency Care While Traveling

Not Covered

Weight-Loss Program

Not Covered

Weight-Loss Surgery

Covered

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2014-05-01