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Health Net California

ValueNet NG Health Insurance Plan with Dental & Vision

A plan summary of the Health Net California ValueNet NG Plan with Dental & Vision is detailed out below for both In Network and Out of Network coverage.

                                                In Network Out of Network

  Copay

    $40

50%

  Office Visits

$35 (Deductible waived for first 2 visits of any combination of professional services and preventive care); additional visits 35% 50%

  Annual Deductible

Individual: $4,000 (Individual Only)

Individual: $4,000 (Individual Only)

  Annual Out-Of-Pocket  Limit

Individual: $3,500 (Individual Only; Deductible not included)

Individual: $7,000 (Individual Only; Deductible not included)

  Lifetime Maximum

Unlimited Unlimited

  Prescription Drugs

$10 Generic

Not Covered

  Laboratory & X-Ray

35% 50%

  Annual Physical Exam

No Charge Not Covered

  Annual OB-GYN Exam

No Charge Not Covered

  Well Baby Care

No Charge Not Covered

  Outpatient Surgery

35% 50%

  Emergency Room

35% 50%

  Inpatient Hospital

35% 50%

  Ambulance

35% 50%

  Home Health Care

35% 50%

  Mental Health - Outpatient

35% 50%

  Chiropractic Care

Not Covered Not Covered

  Acupuncture

Not Covered Not Covered

  Mental Health - Inpatient

  Chemical Dependency

$100 per day (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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