Health Net California
CFB Budget PPO NG 6000 Health Insurance Plan
A plan summary of the Health Net California CFB Budget PPO NG 6000 Plan is detailed out below for both In Network and Out of Network coverage.
In Network |
Out of Network |
Copay |
No Charge after Deductible |
50% |
Office Visits |
$50 (Deductible waived for first two visits) |
50% |
Annual Deductible |
Individual: $6,000 |
Individual: $6,000 |
Annual Out-Of-Pocket Limit |
Individual: $6,000 |
Individual: $6,000
(Deductible not Included) |
Lifetime Maximum |
Unlimited |
Unlimited |
Prescription Drugs |
$500 Ded then $10 Generic/$50 Brand/50% (minimum $50) Non-Formulary/50% (maximum $500) Specialty Drugs
|
Not Covered |
Laboratory & X-Ray |
No Charge after Deductible
|
50% |
Annual Physical Exam |
No Charge (Deductible Waived) |
Not Covered |
Annual OB-GYN Exam |
No Charge (Deductible Waived) |
Not Covered |
Well Baby Care |
No Charge (Deductible Waived) |
Not Covered |
Outpatient Surgery |
No Charge after Deductible |
50% |
Emergency Room |
No Charge after Deductible |
50% |
Inpatient Hospital |
No Charge after Deductible |
50% |
Ambulance |
No Charge after Deductible |
50% |
Home Health Care |
See Brochure |
See Brochure |
Mental Health - Outpatient |
Not Covered |
Not Covered |
Chiropractic Care |
Not Covered |
Not Covered |
Acupuncture |
Not Covered |
Not Covered |
Chemical Dependency |
No Charge after Deductible
(Detox only) |
50% (Detox Only) |
Maternity Care |
Not Covered |
Not Covered |

To learn more about your individual and family California health insurance options, the price of each plan and/or a detailed benefit summary of the plans, visit us here.
NOTICE! Final rates and benefits are based on actual plan selection (including plan riders you may request) and the assignment of any rate adjustment factors due to the health plan's underwriting guidelines.
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