This
information is presented only as a very brief overview of some
of the benefits of this plan, and is intended only for general
education. The amount of benefits provided depends on
the plan selected. Premium will vary with the type of
benefits selected. These plans contain exclusions from
and limitations of coverage. Please see the product brochure
for more complete information, as well as information about
terms of renew ability, preexisting conditions, out-of-network
penalties, and notification requirements. Plans are subject
to health underwriting. To be considered for reimbursement,
expenses must qualify as covered expenses. Expenses are
also subject to reasonable and customary limits, unless you
use a network, and all other policy provisions, including determinations
of medical necessity.
Coverage
Synopsis:
The
SmartChoice HSA plan covers doctor visits, prescription
drugs, vision, accident benefit, and of course, hospitalization.
The deductible is waived for preventive care, including Childhood
Checkups, Immunizations, Vision, Hearing exams through age
18; Annual OB/GYN exams (breast and pelvic exams, cervical
cancer screening and mammography); and prostate exams, all
of which are covered at 100%, after a $35 co-payment.
For adults, routine physical exams, including routine lab
and X-ray services, are also covered, prior to meeting your
deductible, for a co-payment of $70.
The SimpleChoice
HSA plan has similar coverage to the SmartChoice
HSA plan with the exception that you are covered in full
for most services after the deductible has been met (doctor's
visits, annual routine physical exams, x-ray and laboratory
procedures, outpatient surgery, hospitalization, etc.).
Adult preventive care such as annual OB/GYN exams (breast
and pelvic exams, pap smears and mammography), yearly prostate
cancer screening and exam are covered at $100%, after a $40
co-payment and the deductible is waived. The deductible
is also waived after a $40 co-payment for Child Preventive
Care such as checkups, immunizations, vision and hearing exams.
These
plans qualify as HSA-eligible. Combining a Health
Savings Account with any Choice Saver Select plan allows you
to make tax-deductible contributions, pay medical expenses
with pre-tax dollars, and earn tax-deferred interest.
This account works much like an IRA, except you may use your
tax-free savings for qualified medical expenses your health
plan does not cover, such as your deductible, contact lenses,
or most types of alternative medicine (see the HSA qualified
medical expenses page). If you do not use these funds,
they are always yours and continue to grow tax-deferred.
Please
view the Simple Choice HSA and Smart Choice HSA
plans
brochure
for complete details including Plan Provisions, Limitations
& Exclusions, and State Variation information. You
can also refer to the chart above for a coverage overview.
To be considered for reimbursement, expenses must qualify
as covered expenses. Expenses are also subject to reasonable
and customary limits, unless you use a network.
Rate
Information:
Rates
vary based upon zip code, age, and effective date. Please
run an instant
quote to see available rates. Your first month's
premium must be submitted at the time you apply, and can be
paid via check or credit card. Subsequent payments can
be paid by credit card or automatic monthly bank draft.
PPO
Network:
Health Net
has an excellent network of health care providers throughout the
state. The large list of doctors and hospitals can be viewed
at their online
network listings. Please select the PPO – Individual
Plans option.
Underwriting:
Health
Net has a very fast, efficient underwriting process,
especially if no medical records are needed. While it is
always a good idea to apply at least three to four weeks prior
to the time you need your new coverage to take effect, some applications
are approved in less than a week. If medical records are
needed, you may have to reapply, and include medical records.
The company
does have the right to accept or decline any individual or family
application. Certain conditions may be waivered with a temporary
rider (usually for one to two years), or an indefinite rider.
If you are currently being treated for depression, anxiety, or
high cholesterol, please let us know before you apply so we can
avoid unnecessary delays in getting you covered.
Effective
dates:
The coverage
can go into effect in as quickly as the day your application
is approved. You may request an effective date any time
the date after you sign the application and 60 days later.
Please note that you will be billed starting on your requested
effective date, even if you have not yet been notified that
you have been approved. This is very good for someone
who does not have any present coverage and would like for
their benefits to begin as quickly as possible.
For those
who are already covered, it is suggested that you maintain
your current coverage in force until you have received notice
from either HSA for America
or directly from Health Net that your coverage has been approved
and is in force.
HSA
Administrator:
Health
Net has partnered with Bank of America as their HSA administrator.
Benefits include no setup fees, no minimum deposit required,
a low monthly fee of $3.95 per account, online account management
and bill pay, and a Bank of America visa debit card.
Your health
savings account is totally separate from your health insurance,
and you may use any approved bank or trustee as your HSA administrator.
We recommend that you choose one from our HSA
administrator page, where you can compare rates and
features.
About
Health Net:
Health
Net Insurance is among the nation's largest publicly
traded managed health care companies. The company's HMO, POS,
insured PPO and government contracts subsidiaries provide health
benefits to approximately 6.5 million individuals in 27 states
and the District of Columbia through group, individual, Medicare,
Medicaid and TRICARE programs.
Health Net
is an early adopter of the National Committee for Quality Assurance
(NCQA) new quality plus standards for assessing how health plans
measure the quality and efficiency of care provided by physicians
and hospitals in their networks.
Health
Net
has been assigned a rating of B++ (Very Good) from
the A.M.
Best Company, an independent insurance rating organization.
HSA
for America is an independent authorized Health
Net agent.
CA License
#: 0E39302
