About Health Net Health Insurance in California

Health Net, Inc. is a provider of health insurance in the state of California. Since 1998, this company has offered health insurance plans to California residents. Health Net offers Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point of Service (POS) plans for individuals and employers.

History

• Over the span of 17 years, Health Net has carried the company names of GNA Life Insurance Company, Qualmed Health & Life Insurance Company, and Foundation Health Systems Life & Health Insurance Company. Since 1998, Health Net has issued health insurance coverage to customers in California. This managed health care company currently offers its customers a range of health insurance plans, which include plans specifically tailored to individuals, individuals who benefit from Medicare, and employers.

Managed Care

• Health Net is a managed health care company in California, which offers three potential health care plans for its clients: HMOs, PPOs and POS. Although there are stark differences between each type of plan, the common thread that runs through each is that Health Net establishes agreements between itself and a community of doctors, physicians, and hospitals. As Californian policy holders of Health Net search for health care providers, they are generally drawn towards the providers within the community connected with Health Net. This is due to the substantially lower cost of selecting a provider that has agreed to be included in the community of Health Net providers.

HMOs

• HMOs offered by Health Net generally offer the lowest out-of-pocket costs in return for higher monthly premiums (the price the policy holder agrees to pay to the health insurance company) in comparison to the other three types of managed health care plans; this is due to the general inflexibility of choice of health care providers: Unless there is an emergency, the policy holder must use the health care providers within the community of providers affiliated with Health Net. After selecting a primary care physician within the Health Net community, the individual must then utilize that same physician for medical visits and be referred to specialists through the physician.

PPOs

• PPOs allow for greater flexibility than HMOs in exchange for typically higher out-of-pocket costs. Like the HMO, a PPO also includes a community of health care providers by which a policy holder may choose; however, unlike the HMO, a policy holder may choose providers outside the community (at a higher out-of-pocket cost). An advantage to this organization is the freedom to choose a specialist needed for work that the primary care physician has not previously referenced to the policy holder.

POS

• POS plans may be considered a hybrid plan if an individual cannot decide between an HMO or a PPO. POS plans include the same form of community of health care providers as an HMO and includes considerably affordable out-of-pocket costs for visits to physicians within the community; however, unlike an HMO, a POS plan allows for the individual to choose health care providers outside the community in lieu of substantially higher out-of-pocket cost to the policy holder.

Mental Health

• Effective on all policies (excluding Medi-Cal HMOs) beginning on July 1, 2000, and hereafter, the Mental Health Parity Law mandates that health coverage be applied to treatments for policy holders who suffer from mental disorders. These maladies may include anorexia, major depressive disorder, schizophrenia, and more. The law dictates that equivalent coverage be given to mental health and medical treatments within the same policy.

Medi-Cal

• Medi-Cal is a unique health care coverage for people with a low amount of income who live within the state of California. Although it is possible to utilize Medi-Cal in conjunction with a managed care health plan, Health Net only offers health insurance to individuals covered by Medi-Cal within certain counties of California. Medi-Cal managed health policy holders must access Health Net services from Fresno County, Kern County, Los Angeles County, Sacramento County, San Diego County, Stanislaus County, or Tulare County.