Frequently Asked Questions

To get the full benefit of your health plan, it's important that you use providers (doctors, specialists, hospitals, etc.) that are in your plan's network when possible. To locate the provider network your plan uses, look at your member ID card or log in to your online account. You have an Individual & Family plan, and your plan name includes one of these network names:

• Ambetter HMO
• Ambetter PPO

You can select Find a Doctor while you are logged in to your account. Or, if you know your plan name/network, there’s no need to log in; you can simply select Find a Doctor on our home page. Enter the applicable fields in the Search tool and locate your plan’s provider network. You can search for a provider by name, provider ID or license number. You can also use the filters to narrow the type of provider you are looking for.

To change your PCP, log in to your online account and click Select/Change PCP. You will need to search Find a Doctor to make sure the PCP is in your provider network and to get their provider enrollment ID. Please allow 10 days for your account to be updated. You will also receive a new ID card with the name of your selected PCP in approximately 12 to 15 days.

In-network

In-network providers include doctors, hospitals and other health care providers that are contracted with Health Net to provide health care services within your plan's health care network. If you have an Ambetter HMO plan, you must use in-network providers (except for emergency or urgent care and services approved by Health Net).

Out-of-network

Out-of-network providers are doctors, hospitals and other health care providers who are not contracted with Health Net for the plan you selected. If you have an Ambetter PPO plan, you have the option of using out-of-network providers; however, if you use an out-of-network provider, your out-of-pocket costs are usually higher. In addition, doctors, specialists, and hospitals that are not in the network ordinarily can bill you the balance between what they charge and what Health Net pays, with some exceptions for services provided at certain types of in-network facilities.

The Health Net Member portal can be accessed by logging onto the Member section of this website. There you will find the tools you need to manage your health including: enrolling in automatic bill pay, sending secure messaging, printing a temporary Health Net ID card, and much more! If you are trying to access your account for the first time, you will need to register.