Need Care with Your Health Net EnhancedCare PPO?
Use This Key to Start and Go!
Your Health Net EnhancedCare PPO individual health insurance plan has you covered! Through your Health Net EnhancedCare PPO provider network, you have access to doctors, nurses, hospitals, pharmacies, urgent care centers, and more.
And when you need care, you have options. For example, if you think you have the flu, you could see your primary care physician (PCP) or contact Teladoc or schedule a Heal “house call.” Just refer to the chart below to find what you need. You can also print a copy of our Mini Care Key wallet card so your Health Net options can always be close at hand.
Your Care Key
Health Net EnhancedCare PPO – Individual
Use your primary care physician (PCP)
When you need routine and preventive care
For things like annual wellness exams, general medical care
Your PCP’s name and number are on your Health Net ID card
Use Health Net EnhancedCare PPO Network providers
When you need care from specialists and other providers; no PCP referral required
For things like matters of dermatology, obstetrics/gynecology, cardiology, orthopedics, psychology, etc.
Use Teladoc telehealth services
When you need health information, diagnoses and prescriptions by phone, Web or mobile app for non-emergency medical situations or when your PCP’s office is closed1
When you need primary, preventive and urgent care “house calls” from a doctor who comes to your home, office or hotel1
Use Nurse Advice Line
When you need 24/7/365 advice by phone from a registered nurse1
For things like urgent health concerns and care for minor injuries like fevers and the flu
Use walk-in retail clinics, such as MinuteClinics (found in select CVS stores)
When you need in-person care for common illnesses and preventive care1
Use urgent care centers
When you need same-day treatment for non-emergency illnesses or injuries1
Use out-of-network providers
When you need care from health providers outside of the Health Net EnhancedCare PPO Network; additional out-of-pocket costs will apply
For things like routine and specialty care for any health concern
Use Health Benefit Navigator team
When you need help with making the most of your EnhancedCare PPO benefits
For things like deciding when to go where for care, and solving other issues related to your health and your health coverage
1Go immediately to the nearest emergency room or call 911 if you have an emergency.
Tip! Put the addresses for the closest urgent care center and ER in your phone or wallet so you always have them handy. Remember, you’ll pay more out-of-pocket when you go out-of-network. To find in-network providers, just go to Find a Doctor. Then enter your ZIP code and plan type and follow the steps for Urgent Care and Hospital options in your area.
A note about balance billing: Doctors, specialists, emergency rooms, and hospitals that are not in the EnhancedCare PPO Network usually can bill you for any balance between what they charge and what Health Net pays. This is called “balance billing.” The amount Health Net pays – the allowed amount – is set by the insurance plan benefits you have. Balance billing amounts are not covered by your insurance plan. They are in addition to your copayment and monthly premium. And these amounts do not count toward your annual deductible or out-of-pocket maximum. If your doctor refers you to a specialist or to a laboratory for tests, make sure that the provider is in the EnhancedCare PPO Network. That way, you’ll avoid balance billing.