Group Member Forms and Brochures

To view or download a file below, click the topic heading, then click the desired document link. The PDF file will open in your current browser window. From there, you can also download or print the file.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

For members on Health Net Health Plan of Oregon, Inc. plans (PDF)

Complete the claim form for each member submitting bills for reimbursement of covered services. To avoid any delay, be sure to answer each question completely. Please attach fully itemized bills and proof of payment.

Medical Claim Reimbursement Form – English (PDF)

Mail Order Pharmacy

Getting Started With Mail Order Pharmacy Kit
CVS Caremark Mail Order Pharmacy

Medication Therapy Management

Prescription Claims

Approved Drug Lists

The drug list, or formulary, is a list of covered drugs selected by Health Net, along with a team of health care providers. These drugs are selected because they are believed to be a necessary part of a quality treatment program. Our drug lists are updated regularly and are subject to change.

Essential Health Benefit Drug Lists for Group Plans:

Health insurance companies and group health plans are required to make available a uniform glossary of health coverage and medical terms commonly used in plan documents. The Uniform Glossary is meant to help the consumer understand some of the most common language used in health insurance documents. Please log in to request a hard copy of the document by mail.