2014 Health Net Individual Policies

Below you will find information about the plans that Health Net of Oregon will be offering to Oregonians.

CommunityCare Plans

When you need health care, this plan lets you receive services from Providers in our CommunityCare network or outside of our CommunityCare network. Who performs the services determines which benefit level applies to covered services and how much you will pay out-of-pocket.

To receive CommunityCare benefits, you must select a Primary Care Provider (PCP) from our CommunityCare network. Your PCP coordinates all your care. When your PCP refers you to providers in our CommunityCare network, you will receive CommunityCare level benefits. When you receive covered services from Providers in our CommunityCare network, your expenses may include a Calendar Year Deductible, fixed dollar amounts for certain services and a fixed percentage that is applied to our contracted rates with providers in your CommunityCare network. If your PCP refers you to Providers outside of our CommunityCare network, you will receive Level 2 benefits.

Standard PPO Plans

PPO Benefits: When you receive covered services from Providers in our PPO network, your expenses may include a Calendar Year Deductible, fixed dollar amounts for certain services or a fixed percentage that is applied to our contracted rates with PPO Providers.

Out-of-Network Benefits: When services are performed by a Provider who is not in our PPO network, your expenses include a Calendar Year Deductible and a fixed percentage of Maximum Allowable Amount (MAA) rates. We pay Out-of-Network Providers based on MAA rates, not on billed amounts. MAA rates may often be less than the amount a Provider bills for a service. Out-of-Network Providers may therefore hold you responsible for amounts they charge that exceed the MAA rates we pay. Amounts that exceed our MAA rates are not covered and do not apply to your annual out-of-pocket maximum.

Health Net Document Library

Standard PPO Network Plans
Oregon Map

Available: Statewide

First Health, a wholly owned subsidiary of Coventry Health Care, provides national PPO network access and other cost containment programs to help our clients.

  Health Net
Direct
PPO Gold Plan Click to download
PPO Silver Plan Click to download
PPO Bronze Plan Click to download
2014 Application Click to download
Health Net CommunityCare Network
SmartHealth Network Map

Available: Multnomah, Washington and Clackamas counties

Health Net CommunityCare combines a unique blend of benefits, tailored network, and personal and whole health support in one simple package. It offers quality and cost-savings, plus freedom from referral restrictions. CommunityCare is built on a strategic partnership with Portland Metro providers, including Legacy Health, Tuality Healthcare, Adventist Health, and other distinguished providers. It's a community-based, quality-driven network.

  Health Net
Direct
Platinum Plan 10-100-1000 Click to download
Platinum Plan 10-300-2000 Click to download
Platinum Plan 15-500-1500 Click to download
Gold Plan 10-2000-3500 Click to download
Gold Plan 15-1500-3500 Click to download
Gold Plan 20-1000-3000 Click to download
Standard Gold Plan 20-1300-6350 Click to download
Silver Plan 30-3000-6000 Click to download
Silver Plan 35-4000-6000 Click to download
Standard Silver Plan 35-2500-6350 Click to download
Standard Bronze Plan 60-5000-6350 Click to download
2014 Application Click to download