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Health Net PPO Plans with Dental and Vision Included

Health Net HMO Plans

Health Net PPO plans with out Dental and Vision Click Here  

Health Net Plans

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Deductible Out-of-Pocket
Maximum (Preferred Providers)
Physician
Office Visits
(in-network)
Maternity
Care
(in-network)
Prescription
Drugs
(in-network)

Health Net SimpleChoice HSA Plus

Dental and Vision Included

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$4,000 Individual / $8,000 Family  Deductible is out-of-pocket max  Covered in full after deductible is met Not Covered  Covered in full after deductible is met
 


Health Net NetSaver 1500 Plus

Dental and Vision Included
Online Enrollment Only
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$1,500 Individual / 2 per family  $4,000 Individual / 2 per family  Covered in full after OOPM is met Not Covered  Not Covered
 

Health Net PPO ValueChoice 1500 Plus

Dental and Vision Included

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$1,500 Individual (Subscriber only Contract)  $4,000 Individual  Covered in full after OOPM is met Not Covered  $15 (generic only)
 

Health Net SmartChoice HSA Plus

Dental and Vision Included

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$2,500 Individual / $5,000 Family  $4,000 Individual / $10,000 Family  30% Coinsurance Not Covered  30% after plan deductible
 


Health Net SimpleValue 50 Plus Generic
Dental and Vision Included

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$0 (Subscriber Only)  $7,500  $50 Not Covered  $10 Level 1 (generic)
 

Health Net SimpleValue 50 Plus Combo
Dental and Vision Included

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$0 (Subscriber Only)  $7,500  $50 Not Covered  $10 Level 1 (generic); $750 brand deductible; $35 Level II (brand); $50 or 50% whichever is greater Level III (non-formulary)
 

Health Net SimpleValue 40 Plus Generic

Dental and Vision Included

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$0 (Subscriber Only)  $7,500  $40 Not Covered  $10 Level 1 (generic)
 

Health Net PPO SimpleChoice 50 Plus

Dental and Vision Included

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$5,000 Individual / 2 per family  Deductible is out-of-pocket max  Covered in full after deductible is met Not Covered  $5 generic
$250 brand deductible: $35 brand
$50 non-formulary

 

Health Net SimpleValue 30 Plus Generic

Dental and Vision Included

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$0 (Subscriber Only)  $7,500  $30 Not Covered  $10 Level 1 (generic)
 

Health Net SimpleValue 40 Plus Combo

Dental and Vision Included

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$0 (Subscriber Only)  $7,500  $40 Not Covered  $10 Level 1 (generic); $750 brand deductible; $35 Level II (brand); $50 or 50% whichever is greater Level III (non-formulary)
 

Health Net PPO SimpleChoice 35 Plus

Dental and Vision Included

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$3,500 Individual / 2 per family  Deductible is out-of-pocket max  Covered in full after deductible is met Not Covered  $5 generic
$250 brand deductible: $35 brand
$50 non-formulary

 

Health Net SimpleValue 30 Plus Combo
Dental and Vision Included

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$0 (Subscriber Only)  $7,500  $30 Not Covered  $10 Level 1 (generic); $750 brand deductible; $35 Level II (brand); $50 or 50% whichever is greater Level III (non-formulary)
 

Health Net PPO SimpleChoice 40 Plus
Dental and Vision Included

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$4,000 Individual / 2 per family  Deductible is out-of-pocket max  Covered in full after deductible is met Covered in full after deductible is met  $5 generic
$250 brand deductible: $35 brand
$50 non-formulary

 

Health Net PPO SimpleChoice 25 Plus
Dental and Vision Included

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$2,500 Individual / 2 per family  Deductible is out-of-pocket max  Covered in full after deductible is met Not Covered  $5 generic
$250 brand deductible: $35 brand
$50 non-formulary

 

Health Net FirstChoice PPO Plus

Dental and Vision Included

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$3,000 Individual / 2 per family  $3,750 Individual / 2 Per Family  30% Coinsurance Not Covered  $15 (generic only)
 

Health Net PPO SimpleChoice 15 Plus
Dental and Vision Included

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$1,500 Individual / 2 per family  Deductible is out-of-pocket max  Covered in full after deductible is met Not Covered  $5 generic
$250 brand deductible: $35 brand
$50 non-formulary

 

*HMO Coverage is underwritten by Health Net of California, Inc., PPO and Term Life Insurance are underwritten by Health Net Life Insurance Company.
**Dental and Vision Benefits are underwritten by Health Net Life Insurance Company. Dental Benefits are administered by SafeGuard, Vision Benefits are administered by EyeMed Vision Care.
***Term Life Insurance is underwritten by Health Net Life Insurance Company. Term life coverage is only available for the subscriber and is limited to adults at least 19 years old.

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Copyright © 2005 Oleg Skurskiy Authorized Independent Agent, CA License 0E50389