General FAQs

We're here to answer any questions you have about your Health Net plan. If you have a question or concern that is not addressed here, please contact us. Many of your questions can be answered when you log in to your account online.

Choosing or Changing Doctors

Health Net HMO plan members have one main doctor called a Primary Care Physician (PCP). You choose your PCP before you make your payment. That way, your Health Net identification card will have the right doctor information. If you do not select a PCP, we will assign one who is close to where you live.

I already know the name of the Primary Care Physician (PCP) I would like

• Log in to the Health Net member portal
• After you log in, use ProviderSearch to verify the PCP is in your Health Net plan and get his or her Provider ID number.
  • The first set of results in Provider Search will be Health Net plan doctors within a 10-mile radius of your home. Click the "Change Location" link to search a different or larger area.
  • Search for the PCP you want by name or other Search Filter options
  • Copy or note his or her Provider ID Number

  I would like to search for a Primary Care Physician

  • Log in to the Health Net member portal
  • After you log in, use ProviderSearch to find a PCP in your Health Net plan and get his or her Provider ID number.
    • The first set of results in Provider Search will be Health Net plan doctors within a 10-mile radius of your home. Click the "Change Location" link to search a different or larger area.
    • You can filter your results by PCP in addition to selecting a specialty such as Pediatrics or Family Medicine. Click "More Options" again to filter by Gender or Languages spoken.
    • Copy or note his or her Provider ID Number

    Doctor and Provider Network

    How do I find out which providers (doctors, hospitals, etc.) are in my network?

    1. Log in to your member account with your user name and password.
    2. Click on the ProviderSearch link.
    3. Your region and plan information will already appear.
    4. Narrow your search further by selecting type of provider, including:
       • doctors,
       • urgent care and walk-in clinics,
       • hospitals,
       • medical groups,
       • other facilities, and
       • ancillary services.

    Medicare Supplement members:
    You may seek care for covered benefits from any provider that accepts Medicare.

    Am I covered if I seek medical care outside the network?

    HMO, EPO and Health service plan (HSP) members:

    • You are only covered for health care services you get from inside the provider network.
    • In a medical emergency, go straight to the nearest hospital – It does not have to be in your plan's provider network. If you are admitted to a hospital because of an injury or life-threatening medical emergency, you (or someone acting for you) should notify your PCP as soon as reasonably possible.
    • With a PPO, you have the option of getting services "in" or "out" of your plan's network. Going outside of your plan's network may cost you more.
    • Medicare Advantage members:
      In most HMO plans, members can only go to doctors, other health care providers or hospitals in the plan's network, except for:
      • emergency care,
      • out-of-area urgent care, or
      • out-of-area dialysis.

      If you get routine care from out-of-network providers, neither Medicare nor Health Net will pay for the costs.

      In a PPO plan, you can use doctors, hospitals and other health care providers that belong to your plan's network, or you can get care from an out-of-network Medicare provider. It may cost you more to go out-of-network.

      Your Coverage Document will provide detailed information regarding your plan benefits. To view your Coverage Document on www.healthnet.com, you must be registered with our website.

      If you can't find this information, please contact us. We're happy to help!

      If I've been assigned to a primary care physician (PCP) or medical group, how do I find this information?

      You can view this information in one of two ways:

      • It will appear on your Health Net member ID card.
      • This information is also available on the Member site.

      In order to view this information, you must be registered on our website. Once you are logged in, your physician/medical group information is viewable on the main page.

      Please note: Not all plans require an assigned PCP or medical group.

      How do I find the PCP or medical group for my spouse or dependents on my plan?

      1. Log in to your member account with your user name and password.
      2. You will see your member information. If you have access to other members on the policy, you can select their names from the drop-down list called "Viewing information for". The page will refresh with information for the member you selected.

      How do I change my PCP for my HMO or HSP plan?

      Here are some simple steps to take if you want to change your PCP:

      1. Log in to your member account with your user name and password.
      2. Go to ProviderSearch and select a new doctor, then click on View Details.
      3. Next, click on SET AS PCP.

      You can also change your PCP from your member home page. You'll need your new doctor's ID number. After logging in to your member account:

      1. Go to our member home page,
      2. Click the pencil icon that appears next to MY DOCTOR information, then
      3. Enter your new doctor's ID number.

      How do I find out which hospital(s) my medical group is affiliated with?

      If you are a PPO member, you can get care at any hospital, in or out of network, although you will pay more for out-of-network care.

      For HMO, EPO and HSP members:

      1. Log in to your member account with your user name and password.
      2. Click on ProviderSearch.
      3. Click on Change Provider Type below Doctor, and select Medical Group.
      4. Enter the name of the medical group in the search field. (Your plan information will already be filled in.)
      5. Click Search. The Medical group detail page will display.
      6. Scroll down to view this group's hospital affiliations.

      How often are Health Net's online doctor and hospital directories updated?

      ProviderSearch is our online directory of all contracted physicians, hospitals and facilities. While ProviderSearch is updated daily, we suggest you contact the doctor you wish to see to verify that they participate in our network and that they are accepting new patients.

      Security and Registration

      Where can I find my Member ID number?

      This is also called your Subscriber ID number, and you can find it on your Health Net insurance card. When you register, please enter the complete ID number, including all letters and numbers.

      You can also register if you do not know your ID number.

      When I register, should I enter my own date of birth even if I'm not the primary subscriber?

      Yes. If you are registering for a member account for yourself, you should enter your own date of birth.

      What are the rules for choosing a password?

      • Your password must be at least 6 characters long, but not longer than 15 characters.
      • It must contain at least 1 letter and 1 number, and it must be different from your user name.
      • Some special characters are supported, but not all.
      • When logging in, please note that your password is case sensitive.

      Why do I need a password security question?

      If you forget your password, you will be asked to answer your password security question. We will then email you a temporary password so you can access the website and reset your password.

      What if I can't answer my password security question?

      If you cannot answer your security question, please contact us.

      Are there any restrictions on who can and can't use the site?

      If you enrolled in a Health Net plan through a state or federal health care marketplace such as Covered California™ or the Health Insurance Marketplace in Arizona:

      • You must be 12 years or older to use this site.
      • To log in or register for the Member site, you must be the primary subscriber or a dependent on a Health Net plan, or be the parent or guardian of a minor who is the primary subscriber on a Health Net plan.
      • You may register and log in to the Member site once your initial payment has been processed. However, some site features are hidden until your plan is in effect.
      • You may use the Member site for 18 months after your coverage ends.

      For all other users:

      • You must be 12 years or older to use this site.
      • To log in or register for the Member site, you must be the primary subscriber or a dependent on a Health Net policy, or be the parent or guardian of a minor who is the primary subscriber on a Health Net plan.
      • You may register and log in to the Member site beginning on the effective date of your plan and continue using the Member site for 18 months after your coverage ends.

      Why do I need to choose a Sign-In Seal image?

      A Sign-In Seal is a photo that displays on the authentic Health Net website. Look for it every time you log in from a new device or browser, or if you clear your browser's cookies. Using a Sign-In Seal will ensure you are not on a fraudulent phishing site and it is part of Health Net's commitment to your information security.

      Manage My Account/Profile

      How do I register for a member account on healthnet.com?

      1. Go to the Member Registration page.
      2. Complete the member registration form.
      3. Read and agree to the Terms of Use of this website.
      4. Click Register.

      Things you should know before registering:

      • You'll be asked for your Subscriber ID, but you can still register if you don't have it. Your Subscriber ID can be found on your Health Net insurance card. Please enter the complete ID number, including all letters and numbers.
      • Your password must contain a combination of numbers and letters (at least one of each).
        • Your password must be at least 6 characters long, but not longer than 15 characters.
        • It must contain at least 1 letter and 1 number, and it must be different from your user name.
        • Some special characters are supported, but not all.
        • When logging in, please note that your password is case sensitive.

        How do I change my address?

        1. Log in to your member account with your user name and password.
        2. Select the Profile option at the top of the page.
        3. The system will display options to change your contact information.

        If your benefits are through your employer, you may be asked to contact your benefits department or plan administrator.

        How do I get access to view and update information for all enrolled members of the family?

        As the primary subscriber, you and a spouse will have access to profile and plan information for all covered members under the age of 18. This includes the ability to update information, as well. All other enrolled family members will need to register, access the Profile option and select Share Plan Access to allow other adult members on the plan to view or make changes to their information.

        Medicare Advantage and Medicare Supplement plans are individual plans, not family plans. So if you and a spouse are enrolled in the same Health Net plan, you will only have access to view and update information for your own account.

        How do I change my primary care physician (PCP)?

        Note: PPO, EPO and Medicare Supplement members are not required to select a PCP. Only HMO, HSP and CommunityCare members need to select a PCP of their choice.

        In Arizona, HMO, HSP and CommunityCare members are not required to select a PCP.

        1. Log in to your member account with your user name and password.
        2. Go to ProviderSearch, select a new doctor, then click on View Details.
        3. Next, click on SET AS PCP.

        You can also change your PCP from your member home page. You'll need your new doctor's ID number.

        1. Log in to your member account with your user name and password.
        2. Go to the member home page.
        3. Click the pencil icon that appears next to MY DOCTOR information, then enter your new doctor's ID number.

        How do I add or delete family members (newborns, adoptions)?

        If you are enrolled in a Health Net Individual or Family plan through Covered California or your state's Health Insurance Marketplace, you may add or delete enrolled family members during your open enrollment period. In addition, we will generally accept enrollments for newly eligible members within 60 days after the following events:

        • A subscriber's marriage or divorce.
        • Death of a subscriber's spouse or dependent.
        • The birth, adoption or placement for adoption or foster care of a child*.
        • Loss of coverage by a subscriber's spouse.
        • Permanent move.
        • Enrollment errors.
        • Violation of material provision of plan contract.
        • Newly eligible/ineligible for advance payment of the premium tax credit or change in eligibility for cost-sharing reductions.

        Please note: You must submit with proper documentation to Health Net.

        If you are enrolled in an employer sponsored plan, please contact the employer's benefits department for instructions and an enrollment change form, otherwise please contact Health Net Member Services at the number on your ID card.

        Medicare Advantage and Medicare Supplement plans are individual plans. If you or your spouse is eligible for Medicare, learn more or apply online for a Health Net Medicare Advantage or Medicare Supplement plan.

        *In general, an eligible newborn child (or newly adopted child, or child in foster care) is covered for 31 days from his or her date of birth. To continue coverage beyond this initial period, a child must be enrolled within 31 days of birth or placement. Coverage will not begin until application and premium are received within 31 days after birth or placement. If enrollment of the additional dependent is in a higher premium bracket, an additional premium amount is required.