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Overview

Provider Type

  • Participating Physician Groups (PPG)
  • Hospitals 
  • Ancillary

In accordance with the Centers for Medicare and Medicaid Services (CMS) and Department of Health Care Services (DHCS) Health Net Cal MediConnect and its participating providers must provide covered benefits in a manner consistent with professionally recognized standards of health care. If either Medicare or Medi-Cal provides more expansive services than the other program, for a particular condition, type of illness, or diagnosis, Health Net must provide the more expansive set of services to the Cal MediConnect member.

Services listed in the Benefits section provide general information regarding covered benefits for Health Net's Cal MediConnect  plans. In all instances where the benefit information differs from the Provider Participation Agreement (PPA) and  Cal MediConnect  Addendum, the PPA and Cal MediConnect Addendum take precedence.

Last Updated: 11/04/2019