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Health Net BalanceNet Plan Information

The BalanceNet plan from Health Net of California features the following:

Plan Type: PPO
Deductible: $3,500
In-Patient Hospital Co-Payment/Coinsurance: 35%
Prescription Drug Coverage (Out Patient): Yes
Maternity Coverage Included: Yes

Demarketed




BalanceNet Summary:

In Network Out of Network
Annual Deductible Individual: $3,500 Family: $7,000 (Family deductible is met when two family members meet their individual deductibles) Individual: $3,500 Family: $7,000 (Family deductible is met when two family members meet their individual deductibles)
Annual Out-Of-Pocket Limit Individual: $3,500 Family: $7,000 (Family out-of-pocket maximum is met when two family members meet their individual out-of-pocket maximum; Deductible not included) Individual: $3,500 Family: $7,000 (Family out-of-pocket maximum is met when two family members meet their individual out-of-pocket maximum; Deductible not included)
Lifetime Maximum $6,000,000 $6,000,000
Office Visits $35 (Deductible waived for first 2 visits of any combination of professional services and preventive care); additional visits 35% 50%
Prescription Drugs Tier 1: $15 Tier 2: $35 ($2,000 Deductible per member for Tier 2) Not Covered
Laboratory and Radiology No Charge after Deductible 30%
Prescription Drugs $10 generic; $750 brand deductible; $35 preferred brand; 50% or $50 (whichever is greater) non-preferred brand Not Covered
Laboratory and Radiology 35% 50%
Annual Physical Exam $35 (Deductible waived for first 2 visits of any combination of professional services and preventive care); additional visits 35% Not Covered
Annual OB-GYN Exam $35 (Deductible waived for first 2 visits of any combination of professional services and preventive care); additional visits 35% Not Covered
Well Baby Care $35 (Deductible waived for first 2 visits of any combination of professional services and preventive care); additional visits 35% Not Covered
Outpatient Surgery 35% 50% ($600/day max)
Emergency Room 35% 35%
Ambulance 35% 35%
Home Health Care See Brochure for details See Brochure for details
Mental Health Services - Outpatient 35% ($500 annual max) 50% ($500 annual max)
Chiropractic Care Not Covered Not Covered
Acupuncture / Acupressure Not Covered Not Covered
Inpatient Hospital 35% 50% ($600 max/day)
Maternity Care 35% 50%
Mental Health - Inpatient 35% ($5,000 annual max) 50% ($5,000 annual max)
Chemical Dependency See brochure for details See brochure for details

 

IMPORTANT NOTICE: Coinsurance amounts represented with a "%" are payable after the plan deductibles are reached; Co-pay amounts represented with a "$" are not subject to plan deductibles (except where noted). Refer to contract for a detailed explanation of plan benefits, features, exclusions and limitations. Benefits subject to change without notice. Out of pocket maximum shown includes the plan deductible unless otherwise noted. Co-pays, Deductibles, and Coinsurance amounts listed above are your share of the costs for covered benefits.

Do Not Cancel your current coverage until a new policy is approved and you have received written confirmation of the policy's rates and benefits from the insurance company. Rate and Benefit Disclaimer Notification!

Information contained in this website is limited in scope, subject to change without notice, and does not contain all the terms, conditions, limitations, or exclusions of the referenced benefit plans. Only the insurance company Plan Documents and Policy's contain the exact terms and conditions of coverage.

 

 
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