Health Net PPO Advantage

These two plans are the lowest priced PPO plans that Health Net offers.

Health Net PPO Advantage 3500 and 6500 Plans

These two plans are the lowest priced PPO plans that Health Net offers. These are not just popular major medical insurance plans because of the price, but for the comprehensive benefits they provide. They include the no charge annual physical exams and they have a limitation to the number of office visits per calendar year.Cigna health insurance
They have a higher coinsurance percentage and overall higher out of pocket costs to keep the premiums affordable. They also include an embedded deductible. This means that in a family plan, Health Net will begin to pay covered services for each individual in the family once he or she satisfies the annual deductible. The remaining family members must continue to pay a deductible until they either individually meet the individual deductible or until the amount paid by the family reaches the family deductible. You can even turn your health plan into a "Plus" plan by adding on dental, vision and\or supplemental life insurance for an additional premium. The medical plan highlights for in-network services, based on a single person include:

 

Annual Deductible:

$3,500 or $6,500 per calendar year.
   

Out of Pocket Maximum:

$6,500 or $9,500 per calendar year.  Does not include the annual deductible.
   

Physician Visit:

$40 for first 2 visits (not subject to deductible) per calendar year, then you pay 50% coinsurance after the annual deductible for 3 or more visits.
   

Annual Routine Exam:

No Charge (pap smear, mammogram, psa, well baby etc.)
   

X-Ray and Laboratory:

No Charge after out of pocket maximum is met.
   

Prescriptions:

$15 generic, $40 formulary brand, and $60 non formulary brand drugs. All brand drugs subject to a $2,500 annual brand drug deductible.
   

Emergency Room Services:

$100 per visit copayment (waived if admitted) then you pay 50% coinsurance after the annual deductible up to the out of pocket maximum.
   

Ambulance:

No Charge after out of pocket maximum is met.
   

Outpatient Surgery:

You pay 50% coinsurance after the annual deductible up to the out of pocket maximum.
   

Inpatient Hospital:

You pay 50% coinsurance after the annual deductible up to the out of pocket maximum.
   

Maternity care in Hospital:

You pay 50% coinsurance after the annual deductible up to the out of pocket maximum.
   

Mental Health Visits:

No Charge after out of pocket maximum is met for outpatient visits. Inpatient visits you pay 50% coinsurance after the annual deductible up to the out of pocket maximum.
   

Physical Therapy:

No Charge after out of pocket maximum is met.
   

Chiropractic:

Not Covered
   

Acupuncture:

Not Covered
   

Click here for Dental & Vision Summary Benefits and Supplemental Benefits

If you need assistance with individual and family plan options and enrollment, call us to day at
(800) 560-2443

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