2010 - health net€¦ · 5 with healthy heart (ppo), you choose whether to see a doctor in health...

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heAlth net MeDiCARe PlAnsAffordable, reliable, easy.

NORTHERN OREGON & SOUTHWEST WASHINGTON COUNTIES

tAble Of COntents

Welcome to Health Net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

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Health Net Medicare Advantage Plans – overview . . . . . . . . 42010 plan options and benefit highlights

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Get more with Health Net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Decision Power,SM complementary health care, spending safety net and more

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Enrolling is as easy as 1-2-3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Eligibility requirements, important dates

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WelCOMe tO heAlth netSimply A Better DecisionSM

Choosing the right Medicare plan doesn’t have to be difficult. Health Net offers a range of Medicare health plans, so you’re likely to find one that fits your needs. We make evaluating your options simple with color-coded plans to help you differentiate one plan from the other, and our comparisons help you decide which plan is right for you.

Whatever you’re looking for in a Medicare plan, you’ll find it at Health Net. All plans include extra benefits not covered by original Medicare.

Easy. Affordable. Reliable. That’s Health Net.

Our plans are color-coded and easy to understand, and have simple copayments for most benefits.

We make house calls to walk people through our plans and help them decide if Health Net is right for them.

Our highly trained team of nurses, dietitians, and health specialists provide live support for members with chronic conditions and other ongoing health issues. Our pharmacy technicians have helped members save on their drug copayments by switching to generics that are just as effective. And we offer many extra resources to help you make the most of your health.

We are part of your community and passionate about making it easy for our members to get answers and support.

Our financial strength – we’re ranked 165 on the Fortune 500 list of companies – means that we’re strong, stable and built to last. Fortune 500 ranking March 2009.

What makes Health Net A Better Decision?

siMPle

PeRsOnAl

sUPPORtiVe

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ReliAble

THE PPO ADVANTAGE

Enjoy freedom and flexibility to access your health care where you want and when you want

with a Health Net Medicare Advantage PPO plan. You may seek care from any Medicare

provider in the country who agrees to see you as a Medicare member but generally will pay

less when using contracted providers on our in-network list. Either way, doctor visits, hospital

stays, and many other services have a simple copay, which helps to make health care costs

more predictable.

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heAlth net MeDiCARe ADVAntAgeYour health, your choice

Good health means something different to everyone. How you protect yours is an individual choice. That’s why Health Net offers a range of Medicare plans.

•Allofourplansofferfreedom,flexibility,andachoiceofmonthlyplanpremiums to fit your needs and protect yourself or a loved one from unexpected medical expenses.

•Ourprescriptiondrugcoverageincludesmanyofthemostcommonlyprescribed brand-name drugs at an affordable price.

•Weoffertheconvenienceofvirtuallynopaperworkandpersonal customer support.

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With Healthy Heart (PPO), you choose whether to see a doctor in Health Net’s large network or a Medicare provider outside the network. Either way, doctor visits, hospital stays, and many other popular benefits are covered with the same simple copay.

The Healthy Heart (PPO) plan also gives you complete access to our prescription drug plan. Our drug plan is designed specifically for Medicare beneficiaries and includes many of the most commonly prescribed brand-name drugs at an affordable price.

By combining lifestyle support with comprehensive medical and pharmacy coverage, Healthy Heart (PPO) makes it easy for you to make the most of your health.

NEW!HEAlTHY HEArT (PPO)The healthy lifestyle choice

KEY BENEfiTsSame copay for many popular benefits whether you go in- or out-of-network

Access to an extensive range of medical services

All health care and prescription drug needs coordinated through a single company

A comprehensive selection of affordable brand name drugs with no deductible payments on prescription drugs

The convenience of getting your medications from a large network of pharmacies

Preventive dental benefits, complementary care (i.e., acupuncture, naturopathy, and routine chiropractic) and more

Silver&Fit® Program: your choice of membership at a participating fitness club such as Curves® and 24 Hour Fitness®, $150 annual allowance for an out-of-network club, or a home fitness program

Hearing aid allowance ($250 every three years; multi-year benefit may not be available in subsequent years)

Health education, nutrition, diet, weight management and other health-oriented online programs

For 2010, Health Net is introducing Healthy Heart (PPO) – a comprehensive Preferred Provider Organization plan that supports you in living a longer, heart-healthy life. Healthy Heart (PPO) makes it easy to support every aspect of your health – exercise, nutrition, cholesterol levels, diabetes prevention/management and heart – in a single convenient plan.

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With Violet (PPO), you also have the freedom to seek care from any Medicare health provider in the country. Enjoy greater savings by using in-network providers or pay a little more to use out-of-network providers.

Either way, you don’t need a referral from a primary care physician before using services and you pay a simple copay for doctor and hospital visits whether you get care in network or out. Of course, it’s always a good idea to have one main doctor who knows about your full medical history and who can help you maximize your health.

There’s virtually no paperwork or medical claims to file. Plus, an annual out-of-pocket maximum gives you a safety net for unexpected medical costs.

Violet (PPO) also gives you complete access to our prescription drug plan. Our drug plan is designed just for Medicare beneficiaries, and lists many of the most commonly prescribed brand name drugs.

ViOlET (PPO)Comprehensive medical and prescription drug coverage with choice in premium

KEY BENEfiTs

Access to Health Net’s broad range of highly qualified medical professionals

No referrals required No deductible on prescription drugs


The option to seek care from a provider outside of the Health Net network of providers

A comprehensive selection of affordable brand name drugs

Access to Decision Power SM – a unique support service only offered through Health Net

All health care needs coordinated through a single, convenient source

The convenience of getting your medications from a vast network of pharmacies

Health Net Violet (PPO) comes with a $0 monthly premium option.

•VioletOption1(PPO)isidealforthosewhowantcomprehensivebenefitsincluding coverage for routine eyewear, preventive dental, routine physical exams, and alternative care.

•VioletOption2(PPO)withits$0monthlypremiumisgearedtowardthebudget-conscious individual who wants simple copays for doctor office visits and hospital stays.

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Aqua (PPO) is a convenient choice for people who do not want Part D drugs integrated with their medical plan. With Aqua (PPO), you have the freedom to seek care from any Medicare health care provider in the country. When you see a provider in our network, you enjoy greater savings. Whichever you choose, you pay just a simply copay for doctor and hospital visits, and don’t need a referral.

Having one main doctor who knows your full medical history is always a good idea. That way, your doctor can help you maximize your health.

In addition, there’s virtually no paperwork or medical claims to file and an annual out-of-pocket maximum provides you with a safety-net for unexpected medical costs.

AQUA (PPO)Comprehensive medical coverage without Part D coverage

The benefit grids on the following pages are a handy way

to compare our plans side-by-side to find the one that fits you.

KEY BENEfiTs

Access to Health Net’s broad range of highly qualified medical professionals

No referrals required Access to Decision Power SM – a unique support service only offered through Health Net


The option to seek care from a provider outside of the Health Net network of providers

Easy copayments for doctor and specialist visits

Aqua (PPO) is our Health Net Medicare Advantage Preferred Provider Organization without integrated Part D drugs (i.e., MA only). It’s a great choice for people whohavecreditabledrugcoveragethatisnotPartDcoveragebutwantflexible,comprehensive medical coverage.

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2010 benefit highlights

1 Not all plan services are covered under the Out-of-Pocket Maximum (OPM). Preventive dental, routine vision, routine eyewear, complementary care services (naturopathy, acupuncture and routine chiropractic), hearing aids, Medicare-covered chiropractic, fitness club membership and Part D prescription drugs are excluded from the OPM.

2 The annual medical Plan deductible does not apply to the following benefits categories: Primary care or specialist office visits, emergency care, urgent care (in-network only), preventive services, Medicare-covered or routine vision exams, Medicare-covered hearing exam, Medicare-covered or routine chiropractic services, naturopathic services, acupuncture services, preventive dental services, routine eyewear, Part D drugs, outpatient mental health, psychiatric or substance abuse individual or group sessions.

MEDICAL COVERAGE hEALthy hEARt (ppO)

in-network out-of- network

Monthly health plan premium $117

Annual out-of-pocket maximum1 $1,500 $1,500

Annual medical plan deductible2 $0

primary care physician office visit $10 $10

Specialist office visit $10 $10

Inpatient hospital care (per stay) $100 per day,

for days 1-8

$100 per day,

for days 1-8Outpatient surgery (per stay) $100 $100

Lab services $0 $0

Simple X-rays $0 $0

Diabetic supplies $0 $0

Routine annual physical $0 $0

Routine vision exam3 (every 12 months) $10 $0 copayment; health net pays $45 . Member is

responsible for the remaining balance .

Routine eyewear allowance (1 pair every 24 months)4

$100

hearing aids allowance (1 every 36 months)4 $250preventive dental (up to $500 per year) After $35 annual deductible

0% 20% UCR5

Complementary care (up to $500 per year) Routine chiropractic, naturopathy, acupuncture

$15 $15

health club membership/Fitness classes $0 $150 annual allowance

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VIOLEt OptION 1 (ppO) VIOLEt OptION 2 (ppO) AquA (ppO)




$89 $0 $25

$2,000 $3,000 $2,500 $3,500 $1,500 $3,000

$752 $752 $0

$12 $20 $15 $20 $10 $20

$12 $20 $15 $20 $10 $20

$150 per day,

for days 1-8

$200 per day,

for days 1-8

$200 per day,

for days 1-8

$250 per day,

for days 1-8

$100 per day,

for days 1-8

$200 per day,

for days 1-8$150 $200 10% 15% $100 $200

$12 $20 $15 $20 $0 $0

$12 $20 $15 $20 $10 $20

$0 $0 $0 $0 $0 $0

$0 $0 $0 $0 $0 $0

$10 $0 copayment; health net pays $45 . Member is responsible for the remaining

balance .


balance .


balance .$100 not covered $100

not covered not covered not covered

0% 20% UCR5 0% 20% UCR5 0% 20% UCR5

$15 $15 $15 $15 $15 $15

not covered not covered not covered

3 Plan pays up to the allowance amount and member is responsible for any remaining balance.4Multi-year benefit may not be available in subsequent years.5 Based on usual, customary and reasonable rates (UCR). UCR: Usual, Customary and Reasonable means the maximum allowable amount for a dental service based on fees usually charged by providers for that service in the same geographic area. Member is responsible for the difference between UCR and billed charges.

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pRESCRIptION DRuG COVERAGE

hEALthy hEARt (ppO)

VIOLEt OptION 1

(ppO)

VIOLEt OptION 2

(ppO)

AquA (ppO)

Annual part D deductible

$0 $0 $0 Part D drugs are not covered

preferred generic – Retail (30-day supply)

$5 $6 $6

preferred brand – Retail (30-day supply)

$35 $38 $38

Non-preferred generic and brand – Retail (30-day supply)

$70 $76 $76

Injectable/ Specialty drugs

33% 33% 33%

Initial coverage limit $2,830 $2,830 $2,830

Catastrophic coverage After your annual out-of-pocket drug costs reach $4,550, you pay the greater of:• generics (including

brand drugs treated as generic)

• all other drugs

$2 .50 or 5%

$6 .30 or 5%

$2 .50 or 5%

$6 .30 or 5%

$2 .50 or 5%

$6 .30 or 5%

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DentAl AnD VisiOn COVeRAgeHelping protect healthy eyes and bright smiles

PREVENTIVE COVERAGE WITH HEALTH NET

All of our plans come complete with valuable preventive benefits not contained in original Medicare.

Fordental,youhavecoverageforregularpreventiveexams,routinecleaningsandX-raysaftera$35annualdeductible:

SUPPLEMENTAL BENEFIT OPTIONS

You can add a supplemental benefit option to any Health Net Medicare Advantage PPO Plan for an additional monthly plan premium. There are two options to choose from.

•Optional Package #1 provides additional vision and dental benefits that enhance your plan.

•Optional Package #2 combines with your plan benefits to provide a comprehensive dental plan that includes preventive, restorative and major dental benefits.

1 Based on usual, customary and reasonable rates (UCR). UCR: Usual, Customary and Reasonable means the maximum allowable amount for a dental service based on fees usually charged by providers for that service in the same geographic area. Member is responsible for the difference between UCR and billed charges.

2 Multi-year benefit may not be available in subsequent years.

BENEFIt DESCRIptIONhEALthy hEARt (ppO), VIOLEt OptION 1 (ppO)

AND AquA (ppO)VIOLEt OptION 2 (ppO)



Routine vision exam (covered once every 12 months)

$10 copayment $0 copayment;health net pays $45 .

Member is responsible for the remaining balance .

$10 copayment $0 copayment;health net pays $30 .

Member is responsible for the remaining balance .

Routine eyewear (covered once every 24 months)2

$100 allowance not covered

BENEFIt DESCRIptIONpLAN COVERAGE

(IN-NEtWORK)pLAN COVERAGE

(Out-OF-NEtWORK)

2 exams every 12 months 0% coinsurance 20% coinsurance1

2 routine cleanings every 12 months

Bitewing X-rays, once every 12 months

panoramic X-rays, once every 36 months2

Maximum annual preventive benefit $500 per year

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OPtiOnAl PACKAge #1: heAlth net DentAl & VisiOn

DENtAL & VISION Buy-up 2010 MONthLy pLAN pREMIuM

healthy heart (ppO) $19

Violet Option 1 (ppO) $19


Aqua (ppO) $19

DENtAL COVERAGE IN-NEtWORK Out-OF-NEtWORK

$1,000 combined annual benefit limit for all non-Medicare covered dental services. (this combines preventive dental core benefits, where available, and optional benefits.) After $35 annual dental deductible, member pays:

preventive dental • Each 12 months: 2 exams, 2 routine cleanings,

bitewing X-rays• Each 36 months: panoramic X-rays2

0% coinsurance 20% coinsurance of UCR1

Restorative services • Amalgam and resin composite fillings (one per

surface every 3 years)2


periodontal treatment & maintenance (non-surgical)


Other dental services, such as crowns, bridges, root canals and dentures are not covered benefits with the Dental & Vision Optional Package #1.

VISION ALLOWANCE IN- AND Out-OF-NEtWORK

healthy heart (ppO) Additional $150 every 24 months for a total benefit of $2502

Violet Option 1 (ppO)

Aqua (ppO)

Violet Option 2 (ppO) $250 total vision benefit limit every 24 months2



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COMpREhENSIVE DENtAL 2010 MONthLy pLAN pREMIuM

healthy heart (ppO) $50



Aqua (ppO) $50

DENtAL COVERAGE IN-NEtWORK Out-OF-NEtWORK

$1,000 combined annual benefit limit for all non-Medicare covered dental services. (this combines preventive dental core benefits, where available, and optional benefits.) After $35 annual dental deductible, member pays:

preventive dental • Each 12 months: 2 exams, 2 routine cleanings,

bitewing X-rays• Each 36 months: panoramic X-rays2

0% coinsurance 0% coinsurance health net pays 100%

of UCR1

Restorative services • Amalgam and resin composite fillings (one per

surface every 3 years)2


Major services • Periodontal treatment & maintenance• Dentures/bridges• Crowns/inlays/onlays• Extractions• Oral surgery• Endodontics




OPtiOnAl PACKAge #2: heAlth net DentAl MAX ADVAntAge

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seCtiOn 2

get MORe With heAlth netHealth-boosting programs and resources

When you choose a Health Net Medicare Advantage plan, you get more than comprehensive benefit coverage. You get more ways to make the most of your health.

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DECISION POWER SM : HEALTH IN BAL ANCEInformation, resources and support for every person, every stage of health

When you choose Health Net, you get more than health care coverage. You get Decision Power.

Decision Power brings together under one roof the information, resources and personal support that fit you, your health and your life. Whether you’re focused on staying fit, dealing with back pain or facing a serious diagnosis, we’re here to help you work with your doctor and make informed decisions.

Staying healthy is just as important as getting well. Making the most of your health is what Decision Power is all about. We’re focused on your whole health, not just one concern or disease. So we work with you to identify potential health risks, and help prevent minor concerns from becoming big problems. And we’re here should you face serious medical concerns.

Your health, your time. Your choice. Whether you…

•haveaquestion

•wanthelpwithaspecifichealthgoal

•needtreatmentbutwanttounderstandallyouroptions

•arelivingwithillness

…you choose how and when to use the information, resources and support available. Get guidance setting achievable health goals. Focus on weight loss with a step-by-step online plan. Work with a Health Coach to evaluate treatment options.

You can use Decision Power online, or by calling a Health Coach. Try multiple resources at once, or one at a time. 24 hours a day, seven days a week, Decision Power is here for you.

All Health Net Medicare Advantage plans come complete with Decision Power. Because when it comes to your health, there’s more than one right answer.

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1Thereisacombined$500annualcoveragelimitforroutinechiropractic,acupunctureandnaturopathy.2 Complementary care services received out-of-network must be furnished by a provider qualified to provide the benefit in question and who accepts the plan’s terms and conditions of payment.

COMPLEMENTARy HEALTH CARE

Coverage for complementary medicine is another way that Health Net gives you tools to make health care choices. Health Net Medicare Advantage contracts with American Specialty Health Networks (ASH) to provide complementary health care, including routine chiropractic, acupuncture and naturopathy services through the ASH network. If you decide to obtain these services out-of-network, the complementary care provider must agree to Health Net terms and conditions of payment through ASH. ASH administers Health Net Medicare Advantage payments to out-of-network providers.

SPENDING SAFET y NET

All Health Net Medicare Advantage PPO plans include separate in-network and out-of-network Out-of-Pocket Maximum (OPM) spending limits. The Plan OPM is a safety net that limits how much the member spends for Plan-covered services during the year. After you meet the annual in-network OPM, Health Net will pay 100% of OPM-covered in-network services. The same applies to the out-of-network OPM. So, when you look at your Health Net Medicare Advantage PPO plan’s OPM limits, you can rest assured that you’ve got catastrophic protection against unexpected medical costs during the year.

TIERED COPAyMENTS

You pay for some services, supplies and/or equipment on a tiered basis. This means that your copayment is based on what Medicare allows for the item. You pay a higher copayment for more expensive items and/or services, but your copayment is usually just a small percentage of the item’s total cost. Your choice of an in-network or out-of-network provider will also determine how much you will pay for specific services. Benefit categories that offer tiered copayments include radiation therapy, complex imaging services (MRI, CT, PET, MRA) and Medicare Part B drugs.

COMpLEMENtARy CARE BENEFIt IN- AND Out-OF-NEtWORK yOu pAy:

Acupuncture $15 per office visit1,2

Routine chiropractic care $15 per office visit1,2

Naturopathy $15 per office visit1,2

IF thE MEDICARE ALLOWABLE FOR ItEM/SERVICE IS:

IN-NEtWORK yOu pAy:

Out-OF-NEtWORK yOu pAy:

$0-$499 $20 $30

$500-$2,999 $100 $150

$3,000 & up $600 $900

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COST SHARING

You share in the cost of your covered services to achieve an affordable monthly plan premium. To help keep the monthly plan premium more affordable, some plans include a simple plan deductible. A plan deductible is the amount a member pays before selected benefits are covered by the plan. A deductible may not apply to all benefits. Some benefits require coinsurance cost sharing where you pay a percentage of the total cost of a service, based on Medicare-allowable or Health Net contracted costs. With copayments, you only pay a fixed amount at the time of service. Our Member Services and Case Management teams are happy to answer questions about benefit deductibles, copayments or coinsurance. Our phone numbers are listed on the back cover of this booklet.

PRIOR AUTHORIz ATION REqUIREMENTS

Some in-network covered services require prior authorization. Your health care provider usually initiates the process and requests authorization, when required. When specific services are prior authorized by Health Net as medically appropriate, you have the assurance that Health Net will pay for them. If appropriate prior authorizations have not been obtained, services may not be covered or may not be covered in full. The Prior Authorization Reference Guide lists prior authorization requirements. For a copy of this guide, please call us at the phone number listed on the back cover of this booklet.

POST-STABILIz ATION CARE

When the doctors who are giving you emergency care say that your condition is stable and the medical emergency is over, your care proceeds to the “post-stabilization” phase. If you receive inpatient care at an out-of-network hospital after your emergency condition is stabilized, your cost is the cost-sharing you would pay at an in-network hospital.

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seCtiOn 3

enROlling is As eAsY As 1-2-33 easy steps to A Better Decision

When you’re ready, applying for a Health Net Medicare Plan is as easy as, well, 1-2-3:

1. Apply with Health Net by mail, by phone or online, or through your authorized agent or Health Net sales representative.

2. Look for your ID card and plan materials in the mail.

3. Enjoy the benefits of membership – big networks, personal service and groundbreaking wellness resources.

Thank you for considering Health Net.

Want to know more before you choose Health Net? You can get more information by phone or on the Web:

•CallHealthNetat1-800-949-6192(TTY1-800-929-9955forthehearingimpaired) anytime between 8:00 a.m. and 8:00 p.m., 7 days a week.

•Visitusonlineatwww.abetterdecision.com.Youcanfindadoctor, find a drug, find a pharmacy and more.

ELIGIBILIT y

You are eligible to enroll in a Health Net Medicare Advantage plan if:

•YouareentitledtoMedicarePartAandenrolledinMedicarePartB.Membersmustcontinuetopay their Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.

•YoupermanentlyresideintheserviceareaofthePlan.

•Youdonothaveend-stagerenaldisease(ESRD).Exceptionsmayapplyforindividualswhodevelop ESRD while enrolled in a Health Net commercial group plan.

IMPORTANT DATES

Remember, you may only enroll during specific times of the year.

November 15: This is the first day people who are eligible for Medicare can enroll in or disenroll from a Medicare Advantage (MA) and/or Prescription Drug Plan (PDP) with an effective start date of January 1st of the following year.

December 31: The last day people who are eligible for Medicare can enroll in or disenroll from a Medicare Advantage (MA) and/or Prescription Drug Plan (PDP) with an effective start date of January 1st of the following year.

January 1 - March 31: the time when you can join, switch, or drop Medicare Advantage plans as long as you are not adding or dropping Medicare Part D drug coverage. You can only switch plans once during this time.

Special Election Period You may qualify to enroll during other times of the year under a variety of special situations. Please call us to learn about other situations that may qualify you for a Special Election Period.

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Health Net Life Insurance Company is a Medicare Advantage (MA) organization with a Medicare contract. This contract is renewed annually and availability of coverage beyond the end of the contract year is not guaranteed. Anyone entitled to Medicare Part A and enrolled in Part B may apply for Health Net’s MA plans. You must reside in the plan service area in order to apply for Health Net’s MA plans. Medicare beneficiaries can only enroll in these plans during certain times of the year and must continue to pay their Medicare Part B premiums. This document is available in alternative formats.

Plan benefits and cost sharing may vary by plan, county, and region.

In-network providers are those providers who contract with Health Net. Out-of-network providers are those who do not have a contract with Health Net, but accept Medicare’s terms and conditions of payment. Members enrolled in Health Net MA Preferred Provider Organization (PPO) plans can receive care from out-of-network providers. Receiving this care out-of-network may cost more than receiving care from Health Net’s in-network providers, except in emergent or urgent care situations. Health Net will reimburse PPO plan members for covered services received in- or out-of-network as long as the services are medically necessary. PPO members do not need a referral if they are going to see an out-of-network provider. Again, member cost-sharing for covered services may be more if obtaining services from out-of-network providers.

The Medicare Prescription Drug Benefit is only available to members who have enrolled in a Health Net Medicare Advantage with Part D (MA-PD) plan. You must reside in the plan service area in order to apply for Health Net’s MA-PD plans. Eligible Medicare beneficiaries enrolled in Health Net’s MA-PD plans must use network pharmacies to access their prescription drug benefit (except under non-routine circumstances when you cannot reasonably use network pharmacies). Beneficiaries that are already enrolled in a Health Net MA-PD plan must receive their Medicare Prescription Drug Benefit through that plan and may be enrolled in only one MA-PD plan at a time. Beneficiaries enrolled in an MA Plan may not enroll in a PDP, unless they are a member of a Private Fee-for-Service MA Plan (PFFS) that does not provide Medicare prescription drug coverage, a Medical Savings Account MA Plan (MSA), or an 1876 Cost Plan.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for seventy-five percent of drug costs including monthly prescription drug premiums, annual deductibles and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.

Medicare beneficiaries may enroll in Health Net’s MA plans through the Centers for Medicare & Medicaid Services On-line Enrollment Center, located at www.Medicare.gov. For full information on this plan’s benefits, including information on premium withhold or direct bill options, other exclusions, limitations or restrictions to services not already identified in this document, and how to obtain this material in an alternate format, please, contactHealthNetat1-800-949-6192(TTY1-800-929-9955forthehearingimpaired),8:00a.m.to8:00p.m., 7 days a week.

This document is only a summary for informational purposes. It is not a contract. The actual complete terms and conditions of the health plan are set forth in the applicable Evidence of Coverage document.

For Health Net Commercial members: Decision PowerSM is not part of Health Net’s commercial medical benefit plans nor affiliated with Health Net’s provider network and it may be revised or withdrawn without notice. For Health Net Medicare Advantage members: Decision Power is part of Health Net’s Medicare Advantage benefit plans but is not affiliated with Health Net’s provider network. Decision Power services, including Health Coaches, are additional resources that Health Net makes available to enrollees of Health Net Health Plan of Oregon, Inc. and Health Net Life Insurance Company.

Health Net Life Insurance Company is a subsidiary of Health Net, Inc. Health Net® is a registered service mark of Health Net, Inc. A Better DecisionSM and Decision PowerSM are service marks of Health Net, Inc.

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NOT DONE W/THIS yET

6019535OR60295(10/09) Material ID #H5520_2010_0064 CMSapproval:(11/09)

Get the health plan that gives you more. Get Health Net.1-800-949-6192 (tty 1-800-929-9955 for the hearing impaired)

8:00 a.m. to 8:00 p.m., 7 days a week

www.abetterdecision.com

2010 - health net€¦ · 5 with healthy heart (ppo), you choose whether to see a doctor in health...

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