The Health Net Preferred Provider Organization (PPO) health insurance plans are Point of Service health plans that give clients access to a network of 44,000-plus physicians and medical providers in the state of California. People on the Health Net PPO plans can choose any of the doctors within the Health Net PPO network for their medical care needs, or they may see other medical providers that are not in the PPO network for an additional cost. With the Health Net PPO plans, users are not required to get referrals when they see a doctor, and they do not have to see any specific physician or even use any specific network of physicians. Although there is a very extensive network, 44,000 doctors strong, of physicians in the Health Net PPO plan network, users will only need to use a doctor within the network if they want to get the ultimate level of health care coverage allowed under their PPO plan. Even users who select a doctor or health care provider, who is out of the Health Net network, will still have part of their medical care covered, but it will merely be a lower percentage than would have been covered in the network.

 

Two PPO Plan Levels

The typical PPO plan user is someone who wants a wide variety of choices in their health care, and the PPO plan allows exactly that. There are two basic levels to the Health Net PPO plan, both of which the client can use on a case by case basis. The PPO benefit level and the PPO out of network benefit level are both available as needed to each Health Net PPO client. The PPO benefit level offers the greatest level of health care benefits, and is used by those who visit the doctors and health care providers in the Health Net PPO network. Patients using the PPO benefits level can see any physician or specialist within the Health Net PPO network to get treatment for any of the medical conditions covered. No referral is required, and in many cases, you will not need to fill out a claim form. For certain specific services, a brief claim form may be needed, but your insurance agent will let you know exactly when these situations arise if you need to do so. This level of coverage gives you the most coverage and is the easiest way to get medical care within the Health Net PPO plan. The out of network PPO benefit level allows patients to visit licensed doctors or specialists who are not within the Health Net PPO network. No referral is required, but for some of the medical services patients will have to get prior authorization from the Health Net Treatment Review program. When a patients sees a doctor or specialist using the out of network PPO level, they will normally pay a co-insurance amount, and will need to meet a specific yearly deductible before they can receive the maximum possible coverage under this benefit level. Health Care Options for Patients

Patients who want to have the biggest range of health care options will be good candidates for the Health Net PPO health insurance plans. Plan participants are not bound by specific rules on which doctors they can see, although it is most cost effective to see doctors in the Health Net network. Many Health Net PPO plan participants like the flexibility of choosing the benefit level best suited for them at any given time, and like the fact that the coverage levels are clear and understandable. Health Net offers PPO plans with a variety of copayments, deductibles, and coverage amounts: Discuss your own personal health insurance coverage needs with your insurance provider to make certain that you get the Health Net PPO plan best suited for you.