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Enhanced Care PPO

Provider Type

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

Health Net offers the EnhancedCare PPO plan to individuals through Covered California marketplace and directly through Health Net. Individuals enrolled in the EnhancedCare PPO plan will obtain covered services using a select tailored network of participating EnhancedCare PPO providers.

The EnhancedCare PPO plan includes the small business group (SBG) and individual family plan (IFP) products in the following counties:

Enhanced Care PPO Products

Effective date

Product type Counties 
December 1, 2017 SBG Los Angeles
January 1, 2018

IFP

Orange
Placer (partial county)
Los Angeles
Riverside (partial county)
Sacramento
San Bernardino (partial county)
San Diego
Yolo

PCPs and Self-Referrals

Members enrolled in EnhancedCare PPO are required to select a primary care physician (PCP), even though members may self-refer within the EnhancedCare PPO service area for services that do not require prior authorization. The PCP is listed on the member's identification (ID) card.

Out-of-Network Providers

Members receiving care from out-of-network providers have a higher out-of-pocket cost than receiving care from in-network providers. In accordance with Covered California requirements, Health Net EnhancedCare PPO providers must provide advance notice to the member when proposing or considering the use of out-of-network providers for non-emergent services as part of their plan of care for a member. An updated listing of Health Net's EnhancedCare PPO providers is available through the provider portal.

Contact the Health Net Health Benefit Navigator for inquiries about EnhancedCare PPO.

Last Updated: 10/31/2019