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Changing Health Plans

Virtual solutions are becoming the norm, and Health Net is here to help you to live well and work well, through telehealth for medical and mental health support, including urgent prescription orders, as well as appropriate transition of care when you need it, through our case management team and mobile platforms. Plus, we increased our mental health coverage by providing access to a specialized panel of providers.

As you're considering enrolling yourself and your eligible dependents1 with Health Net, we've provided answers to some common questions below.

If you don't find your answer, please call our experienced Health Net Beginnings representatives, Monday through Friday, 8:00 a.m. to 6:00 p.m., at 1-800-526-6694. They can answer your questions to help you choose your health plan and start using your benefits right away.

1 Eligible dependents are defined as your spouse and children. Children, including legally adopted children or children for whom you or your spouse is a legal guardian, are covered up to the age of 26.

Health Net's member-centric programs and services support your whole health, and that includes managing your transition of care. To be eligible for Continuity of Care services, members must be receiving care for one of the six medical conditions listed, which are as follows:

  1. Acute condition – sudden onset of symptom due to illness/injury.
  2. Serious chronic condition – disease/illness/disorder continues without cure and/or requires ongoing treatment; continue until safe to transfer care, up to 12 months.
  3. Pregnancy – three trimesters through postpartum.
  4. Terminal illness – incurable/ irreversible, high probability of causing death.
  5. Care of newborn child – birth through 36 months, with care not to exceed 12 months.
  6. Scheduled surgery – must be plan-authorized and scheduled within 180 days from the provider contract termination date or Health Net effective date of coverage.

Initiating a request for the transition of your care (or Continuity of Care services) process is quite simple:

  • Advise Health Net of any continuity of care needs within 60 days of the effective date of your Health Net coverage or within 30 days of the provider contract termination.
  • A Health Net Continuity Assistance Request Form will be submitted. You will be asked to select a PPG and PCP for any services not directly related to the condition for which continuity of care services are approved.

For prescriptions, you may review the updated drug list, or formulary, of covered drugs selected by Health Net and a team of health care providers. Health Net Large Business Group – 3-Tier with Specialty Drug List can be found on our website.

Employer group pharmacy information

Routine and urgent prescriptions can be filled by your primary care physician. Health Net's telehealth providers can refill urgent prescription if medically necessary and prescribe medication if there is a need, for most situations. Health Net also has prescription transition assistance for new members that will override the need for prior authorization for 6 months to a year for specific prescriptions. You may complete a form to indicate an override request, at the time of enrollment.

Find a Doctor with ProviderSearch

With ProviderSearch, you'll quickly find the most up-to-date listings of qualified in-network doctors, urgent care centers, hospitals, and other types of health care providers near you.

Tip #1: You can easily filter your provider search options by clicking on Select a Plan/Network and selecting the health plan that your employer is offering.

Tip #2: For Dental, Vision and other ancillary providers, click "Ancillary Services."

Find my current medications

You may review the updated drug list, or formulary, of covered drugs selected by Health Net and a team of health care providers. Health Net Large Business Group – 3-Tier with Specialty Drug List can be found on our website.

Employer group pharmacy information

Routine and urgent prescriptions can be filled by your primary care physician. Health Net's telehealth providers can refill urgent prescription if medically necessary and prescribe medication if there is a need, for most situations. Health Net also has prescription transition assistance for new members that will override the need for prior authorization for 6 months to a year for specific prescriptions. You may complete a form to indicate an override request, at the time of enrollment.

It's important to consider your current and upcoming care needs, for yourself or a family member. You will want to stay with your current health plan, or switch to Health Net to access the right doctors, hospitals, prescriptions, and wellness programs and services.

Health Net's member-centric programs and services support your whole health, and that includes managing your transition of care.

If you have specific questions, please call our experienced Health Net Beginnings representatives, Monday through Friday, 8:00 a.m. to 6:00 p.m., at 1-800-526-6694. They can answer your questions to help you choose your health plan and start using your benefits right away.

Life changes, and sometimes, so does your health care needs. One of the advantages of Health Net is that we've been California's health plan for over 40 years. Aside from what your employer offers today, Health Net also provides coverage for every stage of life, regardless of age, income, employment status or current state of health. We provide health plans for individuals, families, businesses of every size, people with Medicare, and people with Medi-Cal. Health Net also offers access to substance abuse programs, behavioral health services, employee assistance programs, and managed health care products related to prescription drugs.

Yes, and in multiple ways, depending on your needs. Let's start at the very beginning – with Health Net Beginnings.

  1. Health Net Beginnings is here to answer your questions to help you choose your health plan, and start using your benefits right away, as soon as you're enrolled. Health Net Beginnings is a toll-free service that offers one-on-one support on topics including:
    • Health Net HMO plan and benefits.
    • Emergency or mental health care.
    • Prior Authorizations for your prescriptions.
    • Whether your doctor or medical group is part of the Health Net provider network.
    • How to set up doctor visits and fill prescriptions before you receive your permanent ID card.

    Our experienced representatives can be reached Monday through Friday, 8:00 a.m. to 6:00 p.m, at 1-800-526-6694, to get you started with your benefits.

  2. Connect with Health Net on the go!

    The easy way to connect to your Health Net online account is Health Net Mobile. You get instant access to:
    • Your plan ID
    • Plan details
    • Your primary care physician information
    • Your ID card
    • The ProviderSearch tool

    Health Net Mobile is available for free on Apple, Android and other web-enabled devices.

  3. 24/7 Nurse Advice Line

    Call our Nurse Advice Line at 1-800-893-5597. A registered nurse is ready to answer your questions anytime – day or night – and guide you to the right services.

When your doctor is not available, or you need same day care, you have access to other providers and resources.

Emergency Room vs. Urgent Care

Know your best option when you need same-day health care services. You can save time, worry and the cost of unnecessary services.

If you have a non-life-threatening situation, urgent care centers are an ideal option. You can get care for many common conditions and enjoy plenty of convenient benefits, including:

  • Economical
  • No appointment required
  • After-hours care
  • Shorter wait times

Not sure which is right for you? Call our 24/7 Nurse Advice Line at 1-800-893-5597. A registered nurse is ready to answer your questions anytime – day or night.

CVS Caremark Mail Service Pharmacy

Get a 90-day supply of your long-term medications. The CVS Caremark Mail Service Pharmacy delivers:

  • Greater convenience – Saves a monthly trip to the retail pharmacy.
  • Lower costs – Mail service 90-day copayment is less than three 30-day, retail pharmacy copayments.
  • Personalized service – You can speak with a registered pharmacist regarding your Rx.
  • Secure delivery – Medication is delivered directly to the location of your choice.
  • No additional cost for shipping or postage!

Everyone needs help sometimes. That's why we're here to help. If you need mental health services or substance use disorder treatment, we'll help you find the right care. When's the right time to seek help? Before a problem turns critical. Health Net offers a few paths:

myStrength

A proven, self-service tool for your mind, body and spirit, myStrength helps you learn to reduce stress, anxiety, depression, or substance use.

  • Free and convenient - With web and mobile apps, you'll have support at home and on the go.
  • Personal and private - Your home page is made for you. myStrength is secure and private.
  • Engaging and inspirational - Activities help you learn new ideas while keeping you motivated!
  • What you'll find on myStrength
    • Personalized workouts - Complete your new custom set of activities every day to support your mental health.
    • Positive inspiration - Find hope with our community of users. We also help you build your own goals.
    • Progress monitoring - Use your Tracker and wellness assessments. You can see how you're doing with the myStrength phone app too.
    • Rock-solid advice - Discover sound tips on relationship and health topics. Explore videos and articles from leading clinicians.

myStrength - How to sign up

  1. Log in to your account and click on the Wellness Center tab to find myStrength; then click Discover myStrength > Go to myStrength from Health Net.
  2. On the Health Net myStrength portal, click Sign Up.
  3. Complete the myStrength sign-up process with a brief wellness assessment and personal profile.
  4. Go mobile! After setting up an online account, download the myStrength app for iOS and Android devices, and register using the same email and password.

Health Net Behavioral Health

Health Net's Behavioral Health services delivers clinically based workplace solutions to enhance the lives of its members. During these trying times, we have increased our mental health coverage by providing access to a specialized panel of providers for mental health. Depending on your plan, Health Net's behavioral health care programs may include:

  • Sessions with a counselor, therapist, psychologist or psychiatrist
  • Treatment in a hospital or residential facility, including partial hospitalization and residential treatment programs
  • Treatment follow-up and aftercare
  • Crisis intervention available 24 hours a day, 365 days a year

Please call Health Net if you need support, want help finding a counselor, psychiatrist or psychologist, or if you have questions about your benefits. Call toll-free 24 hours a day, seven days a week: 1-888-426-0030. TTY users call 711. Or, access Health Net's online provider search.

When it comes to wellness, we know everyone brings a different understanding with unique - and personal - goals. Whether focused on staying fit or facing a serious diagnosis, our Health & Wellness programs can help you and your doctors make the right health and treatment decisions.

The Health Net Wellness online health portal offers our members a central hub for their selected wellness programs and activities, featuring a personalized home page with engaging content to increase online participation. Once you complete the online RealAge Test (health assessment), the home page is updated with personalized recommendations. These may include online wellness programs, telephonic or digital coaching programs, trackers or more!

Health Net Wellness Rewards Program

Get $50 in rewards! Once you're a member just take the online RealAge Test (health assessment) and share the results with your primary care physician (PCP).1

  1. First, log in to your member account and complete the RealAge Test.
  2. Then schedule an appointment for your preventive care physical with your PCP (bring a copy of your RealAge Test to your appointment).
  3. Once you have discussed your RealAge Test results with your PCP, you must log back in to your online account and complete the Primary Care Physician Form to confirm you shared your results with your PCP. Once you have completed these steps, you will be eligible for a $50 gift card reward.

1 Eligible plans include:
All group plans: SmartCare, Salud HMO y Más, HMO Full Network, and PPO plans (including OOS PPO).
Large Group: HMO ExcelCare, EOA and EOA ExcelCare.
Small Group: WholeCare HMO and CommunityCare HMO.
Incentive does not apply to Small Group grandfathered plans.

You Have Health Net Wellness

Health Net Wellness is your bridge to achieving improved wellness and getting the support and confidence you need to take action!

  • Get help with a specific health goal.
  • Track diet, exercise or cholesterol.
  • Try an online health promotion program.
  • Learn about health risks.
  • Explore different treatment options.
  • Adapt to living with an illness.

Health Coaching Program

Working one-on-one with a health coach, you'll:

  • Learn what to expect when trying to make a healthy change.
  • Understand what motivates you.
  • Decide exactly what you want to focus on.
  • Set specific health goals.
  • Track your progress – Your coach will help you stay with it!

Healthy Discounts

Enjoy value-added discounts on lifestyle improvement products and services with Healthy Discounts. These include:

myStrength

Proven tools for your mind, body and spirit, myStrength helps you learn to reduce stress, anxiety, depression, or substance use.

  • Free and convenient - With web and mobile apps, you'll have support at home and on the go.
  • Personal and private - Your home page is made for you. myStrength is secure and private.
  • Engaging and inspirational - Activities help you learn new ideas while keeping you motivated!
  • What you'll find on myStrength
    • Personalized workouts - Complete your new custom set of activities every day to support your mental health.
    • Positive inspiration - Find hope with our community of users. We also help you build your own goals.
    • Progress monitoring - Use your Tracker and wellness assessments. You can see how you're doing with the myStrength phone app too.
    • Rock-solid advice - Discover sound tips on relationship and health topics. Explore videos and articles from leading clinicians.

myStrength - How to sign up

  1. Log in to your member account and click on the Wellness Center tab to find myStrength; then click Discover myStrength > Go to myStrength from Health Net.
  2. On the Health Net myStrength portal, click Sign Up.
  3. Complete the myStrength sign-up process with a brief wellness assessment and personal profile.
  4. Go mobile! After setting up an online account, download the myStrength app for iOS and Android devices, and register using the same email and password.
Last Updated: 11/15/2024