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HMO

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Health Net's HMO plan is a delivery system that offers comprehensive health care, including preventive services. In return, the member is responsible for a copayment, which is a fixed dollar amount per service. Members are required to select a primary care physician (PCP) and a participating physician group (PPG) upon enrollment. Each family member may select a different PCP. The PCP is responsible for providing or coordinating all health care services. If a member requires services outside the PCP's scope of practice, the PCP refers the member to a specialist or other ancillary provider. Members who bypass their PCP risk loss of coverage for the services provided without the PCP's referral.

Last Updated: 10/31/2019