Health Net Insurance Review & Complaints: Health Insurance (2024)

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California-born Health Net Insurance is a nationwide health insurance company that provides a wide array of plans including individual and group plans as well as administration of Medicare, Medicaid, and Veterans Affairs programs. As of 2016, Health Net operates as a subsidiary of Centene and serves all 50 states as well as the District of Columbia. Our Health Net insurance review covers the history, health coverage options and current ratings of this company.

About Health Net

Health Net Medical originated in 1977 as a nonprofit entity, maintaining this status until 1992, when it shifted towards for-profit activities. Initially established in California, Health Net Medical experienced rapid growth, notably through the merger with Qualmed in 1993, leading to the establishment of Health Systems International. Another significant merger occurred in 1997 with Foundation Health Systems, propelling Health Net Medical to become the 4th largest insurer in the United States, with operations spanning 17 states. By the year 2000, the company reverted to its original name, Health Net Commercial..

In March 2016, Centene acquired Health Net, keeping its name intact. Now, Health Net services are available nationwide through various branches. However, issues may arise, especially regarding Health Net dental insurance.

Health Net’s individual health insurance plans are only offered in three Western states: California, Oregon, and Arizona. In the remainder of the country, they offer mainly government-sponsored products, administrating Veteran’s Affairs programs, Medicaid, and Medicare. They are one of the biggest insurance companies in California and also manage Medi-Cal and other government programs.

Health Net has headquarters in two locations; the California office is located in Woodland Hills, CA, and a second location is in St. Louis, MA.

Health Net Insurance Products

In the mentioned states, Health Net provides comprehensive health insurance plans, which are available for individual purchase or as part of employee group benefits. Additionally, Health Net serves as an administrator for various government plans. In this review, we concentrated on the health insurance plans accessible in California, keeping a focus on aspects such as coverage for Health Net dermatologists and Health Net gynecologist, as well as services provided by Health Net Federal Services.

Individual Health Plans

Plans in California are divided into those offered under the Covered California system as well as directly through Health Net. Covered California plans are only available to those who qualify based on income. The plans are similar, but they have some differences in out of pocket costs.

There are three types of plans available: PPO, EPO, and HMO. They vary based on the zip code of the applicant. Most of the plans feature a number in the name that is the coinsurance amount on the plan; copays and deductibles vary.

EnhancedCare PPO

The EnhancedCare PPO plans are offered at multiple levels that vary by coinsurance amount.

They start with the Minimum Coverage (catastrophic) plan and range up to the Platinum 90 plan that has the least amount of out of pocket expense of any of the plans. All of these plans have access to the EnhancedCare PPO network and also provide coverage for out-of-network care. There is one off-exchange plan in this category.

The Catastrophic plan provides three primary care visits free of charge and exempt from the deductible each year. After that, all care is subject to the deductible, and when that is met all care is covered at 100%. The deductible is $7,350 individual (all deductibles are doubled for family).

The Bronze plan has a slightly lower deductible at $6,300, with an out-of-pocket maximum at $7,000. The first three primary care visits are not subject to the deductible and have a $75 copay; this copay applies again after the deductible is met and until the out of pocket max is met.

The Silver plan has a much lower deductible at $2,500. The deductible does not apply to any office visits nor to many other services that instead have copays and coinsurance amounts. Primary care office visits have a $35 copay, specialists $75.

The Gold plan has no deductible for in-network care and copays are $25 for primary care and $55 for a specialist.

The Platinum plan also has no deductible and lower out of pocket costs, with primary care visits at $15 and specialists at $30.

All of the plans include prescription drug coverage.

Other Plans

The regular PPO plans follow the health care exchange’s metal tier levels, starting at the Minimum Coverage plan and going up to the Platinum 90 plan. These are very similar to the EnhancedCare but cover a different region and have a different network. Again, out of network coverage is available. Coverage is much the same as the EnhancedCare PPO plans, with the same deductibles and copays.

The PureCare One EPO plans again come in levels from catastrophic up to Platinum. As an EPO, there is no out of network coverage. There is one Silver level plan that is an off-exchange plan. Again, these plans have the same deductibles and copays as the EnhancedCare plans described above.

The PureCare HSA plans are only offered at catastrophic and bronze levels, which is pretty common for this type of plan. They utilize a Health Savings Account through which all medical bills can be paid until the deductible is met, after which coverage is at 100%.

Finally, there are three CommunityCare HMO plans, offered at Bronze, Silver, and Gold levels. These are managed care plans that limit access to only the provider network and usually require specialist referrals. These tend to be the most affordable plans due to the managed care system. These plans also follow the same pattern of deductibles and copays as the PPO plans. (For more information, read our “CommunityCare Medicare Insurance Review & Complaints: Health Insurance“)

Medicare Plans

Health Net Insurance writes Medicare Advantage plans in California, Arizona, Oregon, and Washington. The plans vary by state.

In California, Medicare Advantage plans are available at a variety of levels, all with HMO coverage and with varying out of pocket costs. Medicare Supplement plans are also available at several levels.

For more information on Health Net’s Medicare options, read our Medicare-specific review.

Rates

We collected quotes within our designated area for a solitary 30-year-old, yielding diverse rates across multiple plan options, despite prevailing Health Net complaints

The lowest rate was for the Minimum Coverage EnhancedCare PPO $207.49, with the Minimum Coverage HSA plan slight more expensive at $235.06.

The mid-range plan, the Silver EnhancedCare, came in at $358.91 a month, while the most expensive plan – the Platinum – was $596.78.

We also received some HMO plan choices, with a Silver HMO plan coming in at $271.72 and the Platinum at $419.

These rates are generally in line with what we have seen elsewhere, with the PPO plans not surprisingly are more expensive than the HMO, but not by a large amount.

Health Net Insurance Claims Process

Ease of Filing a Claim (Online, Over the Phone, Mobile Apps)

Health Net Insurance offers multiple channels for filing claims to make it convenient for policyholders. You can file a claim online through their website, over the phone, or even through mobile apps, ensuring flexibility and ease of access for all policyholders.

Average Claim Processing Time

The average claim processing time with Health Net Insurance can vary depending on the complexity of the claim and the specific policy details. However, Health Net aims to process claims efficiently and strives to provide timely responses to policyholders.

Customer Feedback on Claim Resolutions and Payouts

Insights from customer reviews about claim resolutions and payouts are crucial in assessing an insurance company’s effectiveness. While Health Net Insurance presents diverse health insurance options, it’s pivotal for clients to communicate their encounters concerning claim filing convenience, processing speed, and overall satisfaction with claim resolutions and payouts. Additionally, individuals can utilize resources such as the Health Net provider portal and Health Net provider search tools to navigate their coverage and access services efficiently. Moreover, Health Net’s pharmacy benefit management (PBM) services play a significant role in ensuring seamless medication access for policyholders.

Digital and Technological Features of Health Net Insurance

Mobile App Features and Functionality

Health Net Insurance offers a mobile app with a variety of features and functionalities to enhance the customer experience. Policyholders can use the app to access their insurance information, view claims status, find healthcare providers, and even file claims conveniently from their mobile devices.

Online Account Management Capabilities

Health Net Insurance provides robust online account management capabilities through their website. Policyholders can log in to their accounts to review policy details, make premium payments, update personal information, and track claims progress, ensuring convenient self-service options.

Digital Tools and Resources

Health Net Insurance may also provide a range of digital resources and tools alongside mobile applications and online account management. These digital assets aim to assist policyholders in making well-informed healthcare choices. Such resources could encompass calculators for estimating costs, listings of prescription drug formulas, and wellness materials designed to promote overall health and enhance well-being. Moreover, Health Net may offer access to information about nearby hospitals and healthcare facilities, including Health Net hospitals near me, to further support individuals in their healthcare decisions.

The advanced digital tools and technological advancements enhance the contemporary and streamlined insurance journey for Health Net clients in Indianapolis, enabling them to effortlessly oversee their policies and obtain crucial information.

Ratings and Consumer Reviews

There is a variety of Better Business Bureau (BBB) pages for Health Net’s different branches. Health Net of California at the Woodland Hills headquarters has a D rating with the BBB. The file lists failure to respond to eight complaints and six complaints that were not resolved as the reason for the reduced rating. There is a total of 82 complaints on this file in the past three years.

Health Net Plan of Oregon has a B- rating, with the rating lowered for failure to respond to two complaints. The Arizona branch is doing better, with an A+ rating and only 16 complaints in the last three years. There appears to be a pretty big difference in how each branch is performing, even when providing the same level of coverage, but it’s worth noting that the California branch is by far the largest and thus likely to have more complaints.

On Consumer Affairs, Health Net has amassed a total of 208 evaluations, resulting in a single-star rating primarily driven by 42 reviews submitted within the past year. Among the prevalent grievances are issues surrounding subpar customer service, deceptive sales representations, and challenges encountered when attempting to locate in-network healthcare providers. These concerns are particularly noteworthy in light of ongoing discussions regarding the Health Net class action lawsuit.

The Health Net ratings on Yelp are similarly negative, with an overall one-star rating resulting from 155 reviews. Billing mistakes resulting in cancellation are a common complaint here.

Considering the challenges highlighted by the BBB and the recurrent nature of complaints against Health Net, there are reasons to be concerned about how they handle customer service and billing matters. If you need to contact Health Net in California, you can reach out via their provider phone number.

The Bottom Line

Health Net Insurance has a lot of plans, and the availability depends on where you live. Their rates are fairly average, with a lot of options to fit just about any budget. The Health Net website provides visitors with more information on their healthcare coverage options. Their reputation, however, leaves something to be desired – it is hard to ignore a D rating from the BBB – which leaves us to recommend that those seeking individual health insurance look elsewhere. They do appear to have a better reputation in Arizona, so insurance shoppers in that state might want to keep them on the list.