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Health Net - Medicare Advantage Plans Health Heart, Ruby, Amber, Violet |
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Health Net

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Summary of Benefits Healthy Heart 1 - 2012

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The Healthy Heart Plan (HMO) is a comprehensive Medicare Advantage plan that supports you living a longer, heart-healthy life. Healthy Heart makes it easy to support every aspect of your health - exercise, nutrition, cholesterol levels, diabetes prevention/management and heart-in a single convenient plan. This plan includes medical and Part D prescription drug coverage in one package.
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Plan 1
Monthly premium: $0.00 Deductible: N/A Out-of-pocket maximum: $3,400 Primary doctor copay: $0.00 Specialist copay: $0.00 Coverage in the gap: N/A Generic drug copay: $5.00 Preferred drug copay: $42.00 Non-preferred drug copay: $84.00
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Healthy Heart 2
More MD's....

Plan Summary: Health Net Healthy Heart is a comprehensive HMO plan that supports you living a longer, heart-healthy life. Healthy Heart makes it easy to support every aspect of your health - exercise, nutrition, cholesterol levels, diabetes prevention/ management and heart-in a single convenient plan
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Summary of Benefits

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Amber (HMO SNP) is Health Net's Medicare Advantage Special Needs Plan (SNP) that includes access to our prescription drug plan.
The Amber plan is available to individuals who are dually enrolled in Medicare and Medicaid. The plan provides reduced or eliminated premiums, deductibles and reduced coinsurance or copayment to those who qualify. Amber plans, for partial and full dual eligible members, are offered in certain California counties and Arizona only.
Eligibility for Amber - Dual Eligible is based on qualified financial status as determined by government guidelines.
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Ruby (HMO) is our HMO, or Health Maintenance Organization, medical plan that comes with our cost-effective Prescription Drug Plan.
Ruby also gives you access to our extensive group of medical providers along with the flexibility to choose among them. Your clients can look forward to choosing a Primary Care Physician from a large group of highly skilled physicians in your clients' area. Your clients can expect excellent care. Plus, with Ruby, there's virtually no paperwork.
Ruby gives you complete access to our Prescription Drug Plan, which includes many of the most commonly prescribed brand-name drugs for the conditions most likely to affect your clients, at an affordable price.
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Monthly premium: $0.00
Deductible: N/A
Out-of-pocket maximum: $3,400
Primary doctor copay: $8.00
Specialist copay: $10.00
Coverage in the gap: N/A
Generic drug copay: $5.00
Preferred drug copay: $42.00
Non-preferred drug copay: $84.00
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Summary of Benefits
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Violet (PPO) is our PPO, or Preferred Provider Organization, medical plan that comes with our cost-effective Prescription Drug coverage.
This gives you the convenience of having all their medical and prescription drug needs covered by one carrier.
Violet gives you access to Health Net's broad network of health care providers or your clients have the freedom to go outside our network and seek care from any Medicare-participating provider in the U.S.
With Violet, when you stay within our network, there's virtually no paperwork or claims to file, and no referrals are needed. Should you choose to use an out-of-network provider, they may only pay a little more. Plus, Violet comes with our prescription drug plan, which places many of the most commonly prescribed brand-name drugs in our most affordable price categories.
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Green (HMO) is our HMO, or Health Maintenance Organization, plan that offers medical coverage only.
Green gives you the flexibility to choose from our many medical providers. You can choose a Primary Care Physician from a large group of highly skilled physicians in your clients' area. You can expect excellent care. Plus, with Green, there's virtually no paperwork.
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Amber CHF (HMO SNP) is Health Net's Medicare Advantage Special Needs Chronic Plan (SNP) that includes access to our prescription drug plan.
The Amber CHF plan is available only to individuals diagnosed with Congestive Heart Failure (CHF). Eligibility for Amber CHF must be confirmed by your client's physician either before enrollment or within 30 days of enrollment.
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Part D Value Formulary |
Classic Formulary |
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Medicare Supplement plan is designed to supplement Original Medicare.
With Health Net's Medicare Supplement Plans one can usually see any doctor who accepts Medicare, including specialists, at any time, without referrals or authorizations. You get peace of mind from seeing the doctor of their choice, and savings from a plan that helps pay for Medicare deductibles, coinsurance and more.
Health Net Member Services 800.275.4737
Amber 800.431.9007
Fraud Unit 800.977.3565
Integrity 888.866.1366

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Historical Information
Not all of these Health Net plan options are available in every Area. Click here for pricing & benefits & availability.
Medicare Advantage Plans
with built-in prescription drug plan (includes Special Needs Plans)
Plans offering both medical and drug coverage.
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Amber 1 |
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Amber 2 |
Monthly premium: $0.10- $29.10**
Deductible: $0
Primary doctor copay: $0.00
Specialist copay: $0.00
Coverage in the gap: Yes
Generic drug copay: $0.00 / $1.10 / $2.50*
Preferred drug copay: $0.00 / $1.10 / $2.50*
Non-preferred drug copay: $0.00 / $3.30 / $6.30*Chiropractic*
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Same |
*Summary of Benefits
Evidence
of Coverage |
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Summary of Benefits
Evidence of Coverage |
Amber 1 is for Partial Eligibles and gives
48 one way trips to the Doctor
and depending on LIS (Low
Income Subsidy) higher copays. |
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Amber 2 is for Full Dual and has unlimited
transportation to the Doctor. |
Medicare Advantage with
no prescription drug program
Plans offering medical benefits but no prescription drug coverage.
THE GREEN PLAN
(can NOT get a separate Part D - Rx Plan, OK if you have VA Rx or Group Rx)
Monthly premium: $0.00
Deductible: $0
Primary doctor copay: $7.00
Specialist copay: $10.00
Summary of Benefits
Evidence of Coverage
application






We also have plans if you have Medicare and you are under 65
Broker ONLY
HN Forms & Brochures
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Producer Manual
Do's & Don'ts
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Monthly premium: $0.00
Deductible: $0.00
Primary doctor copay: $0.00
Specialist copay: $0.00
Coverage in the gap: Preferred Generic
Generic drug copay: $5.00
Preferred drug copay: $39.00
Non-preferred drug copay: $78.00
Formulary
Pharmacy
directory
Enrollment Application for ALL plans
Monthly premium: $0.00
Deductible: $0
Primary doctor copay: $0.00
Specialist copay: $0.00
Coverage in the gap: Preferred Generic Tiers 1 and 2
Generic drug copay: $5.00
Preferred drug copay: $39.00
Non-preferred drug copay: $78.00
Summary of Benefits
Evidence of Coverage
Monthly premium: $0.00
Deductible: $0
Primary doctor copay: $8.00
Specialist copay: $11.00
Coverage in the gap: Preferred Generic
Generic drug copay: $5.00
Preferred drug copay: $39.00
Non-preferred drug copay: $78.00
Summary of Benefits
Evidence of Coverage
Broker ONLY
Training Not for Sales or Marketing!
800.708.7646
Forms
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