Is Health Net a good HMO network? I have no idea what I’m doing any input appreciated
This seems a good HMO plan to me- I pay more per month for my PPO plan, which has worse residuals (deductible, Out of Pocket Max, etc ) than what your document says.
The thing to be aware of with HMO’s is that you are at the most risk of paying a lot when you go outside the network for anything except emergency services.
In terms of the health care part of the deal, an HMO works by having some of the choices of care be routed through the patient’s primary care doctor, having the patient first try services within the network’s doctors, and only covering non-emergency services outside the network following prior authorization approval. This network is usually separated a separate entity called a Medical Group that represents a group of doctor offices and healthcare providers that have a contract with Healthnet to provide care to the HMO’s members.
In terms of the quality of the healthcare, that is for you to determine- some HMO networks are excellent, cover a lot of services, and generally can turn around claims and prior auth’s quicker than the regulatory guidelines. Others suck for one reason or another.
As Health Net is a large insurance company, I suspect they will have a medical group in your local area be the Medical Group, so it would be smart to check whether how you feel about the med group before making your final decision.
Hope this helps!
