Overview
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Ancillary
Prosthetics needs may be referred to any Health Net participating provider. Health Net has a supplier contract with Linkia, LLC, which is Health Net's preferred provider for orthotics and prostheses. Health Net encourages the use of Linkia for these services whenever possible. For those prosthetics supplies not available through Linkia, they may be obtained by any other Health Net contracting provider.
Prostheses and supplies include:
- artificial limbs
- artificial eyes
- artificial larynx devices after a laryngectomy
- breast prostheses
- colostomy and ostomy supplies
- contact lenses after cataract surgery
- C.V., midline and peripheral catheters
- enteral supplies
- phenylketonuria (PKU) formulas and food products
- tracheostomy supplies
- ventilator supplies
Breast Prostheses
When a member receives reconstructive breast surgery after a medically necessary mastectomy, prescribed prostheses are covered and replaceable when no longer functional. In addition, prescribed prostheses are covered and replaceable when no longer functional if surgery to the healthy breast is performed to restore and achieve symmetry. Benefits for prostheses include two mastectomy bras each year. If the original mastectomy was not medically necessary, the cost of a new prosthetic is not covered. Repair or replacement of prostheses is covered. Repair or replacement due to misuse or loss is not covered.
Post-Cataract Benefits
Health Net covers the surgically implanted conventional intraocular lens (IOL) and a pair of glasses to replace the organic eye lens following the surgical extraction of a cataract. Post-cataract surgery eyeglasses or post-cataract surgery contact lenses are covered under the prosthetic benefit for members who did not receive an implanted lens after lens extraction.
Preferred Provider
Linkia, LLC provides both prostheses and the supplies required to maintain prostheses, which are also covered. Contact Linkia to obtain the telephone number of the nearest location. Covered prostheses supplies that are not provided by Linkia may be obtained through any Health Net contracting provider.