Plan Options and Coverage
Check your coverage documents.
- Log in to your account with your user name and password
- Look for the Plan Overview column on the My Health Plan page
- Select the option to View Documents next to the Coverage Document label
- Selecting the linked text will open a PDF version of your coverage document
If your coverage documents are not available, please call Member Services at the number on your ID card.
Most Health Net plan members have access to mental and behavioral health care benefits through MHN, a Health Net company. Please see the back of your ID card or refer to your plan documents for your individual benefits.
Health Net offers a variety of alternative care benefit options, including discounts and coverage integrated with certain plans.
To find out if your plan includes alternative care coverage, please view your plan documents.
Log in to view my plan documents
Some Health Net plans also offer Healthy Discounts giving members discounts on alternative care services. To explore these options, log in and visit the Wellness Center, or refer to your plan’s Healthy Discounts brochure.
You can search for alternative care providers using our ProviderSearch tool.
Note: We can only supply EOBs for claims processed at Health Net directly.
Please contact your medical group or your primary insurance carrier for assistance with acquiring EOBs for claims they have processed.
For claims processed by Health Net:
- Log in to your account with your user name and password
- Select My Plan Activity from the main navigation bar
- Select Claims from the sub navigation menu
- Search EOB from the list of available page options
To download and print a Claim Form:
- Log in to your account with your user name and password
- From My Plan Activity, under the Claims section, select Claim Forms
- Select the appropriate claim form
You will be asked to provide the bill and proof of payment. For full instructions, see the claim form.
- Log in to your account with your user name and password
- Select My Plan Activity from the main navigation bar
- Select Claims
- Select Claims History and view your claims information
You can also select Search Explanation of Benefits (EOB) from the list of available page options to view your available EOB.
If you need help, you can also call our Member Services at the number on your ID card.
Some plans offer Healthy Discounts giving members discounts on fitness clubs, weight management, vision services, alternative care services, and more. To explore these offers, log in and visit the Wellness Center or your plan’s Healthy Discounts brochure.
Preferred Provider Organization (PPO)
A PPO is also a type of health coverage with a set network of health care providers. You can see providers outside of the network, but you may pay more. You can also go to a specialist without getting a referral.
A PPO is right for you if:
- You want the largest network of providers statewide
- You want the option to get services “in or “out” of your plan’s network
- No need to select a PCP for your ID card
Exclusive Provider Organization (EPO)
An EPO is a type of health coverage that also has a network of health care providers. Like an HMO, you must use health care providers within your network. You will need to select a PCP and get a referral to see a specialist within the network.
An EPO is right for you if:
- You want your PCP to coordinate your care
- Stay within a network of providers for the lowest cost
- You want lower out of pocket costs
- Your PCP will be listed on your ID card
Community Care (CC)
Tailored network in the Portland Metropolitan utilizing the Legacy network of providers. Built on strategic relationships in Oregon, CommunityCare is available in Multnomah, Clackamas, Washington, Clatsop, Columbia, and Tillamook counties.
A Community Care is right for you if:
- You would select a PCP and they would be listed on your ID card
- Lower out of pocket costs
- Lower premium costs
- You can see most specialists without a referral