Overview

Health Net's Cal MediConnect program's goal is to improve the quality of care for its members eligible for Medicare and Medi-Cal by providing access to seamless, integrated care.

Health Net's Medicare Advantage (MA) HMO benefits are the Cal MediConnect member's primary benefits. These benefits include medically necessary services, such as acute care services, physician services, hospital services, temporary skilled nursing facility (SNF) services, dialysis, durable medical equipment (DME), and home health services. Medi-Cal managed care benefits provide secondary benefits and generally cover services not covered under MA HMO benefits. This may include transportation, dental, vision, and some mental health services. It also includes services delivered after the MA HMO benefit is exhausted or specific criteria has not been met, and services including long-term care, custodial nursing facility care, home and community-based services, and personal care services.