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Extension of Benefits

Provider Type

  • Hospitals

Application for extension of benefits must be submitted by the member and certification of the disabling condition completed within 90 days following the date the group agreement terminated. The request for extension of benefits must include written certification by the member's physician that the member is totally disabled.

If benefits are extended because of total disability, the member must provide Health Net with proof of total disability at least once every 90 days during the extension, before the end of the 90-day period.

The extension of benefits ends on the earliest of any of the following dates:

  1. On the date the member is no longer totally disabled.
  2. On the date the member becomes covered by a replacement health policy or plan obtained by the group and this coverage has no limitation for the disabling condition.
  3. On the date that available benefits are exhausted.
  4. On the last day of the 12-month period following the date the extension began.

Refer to the member's Evidence of Coverage (EOC) for additional information, or contact the Health Net Provider Services Center.

Last Updated: 10/30/2019