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Health Net Bronze 60 HSP

Health Net Bronze 60 HSP	In-Network
Cost Share Information
Individual Deductible	$6,300
Family Deductible	$12,600
Out of Pocket Limit-Individual	$6,800 (including deductible)
Out of Pocket Limit-Family	$13,600 (including deductible)
Co-Insurance	100%
Lifetime Maximum	Unlimited
Office Visits
Primary Care	$75 deductible waived for 1st 3 visits
Specialist	$105 deductible waived for 1st 3 visits
Adult Preventive Care	No Charge
Child Preventive Care	No Charge
Maternity Prenatal/Postnatal Care	No Charge
Rehabilitation Services	$75 deductible waived
Chiropractic Care	Not Covered
Inpatient Services
Inpatient Hospital	100% after deductible (up to OOP)
Maternity Delivery/Inpatient	100% after deductible (up to OOP)
Outpatient Services
Outpatient Facility	100% after deductible (up to OOP)
Mental Health Outpatient	$75 deductible waived
Lab/X-Ray	$40 deductible waived/100% after deductible
Emergency Care
Emergency Room	100% after deductible (up to OOP)
Urgent Care	$75 deductible waived 1st 3 visits
Ambulance	100% after deductible (up to OOP)
Prescription Drugs
Rx Deductible	$500 individual/$1000 family
Rx Generic	100% after deductible (up to OOP); $500 max/script
Rx Preferred	100% after deductible (up to OOP); $500 max/script
Rx Non-Preferred	100% after deductible (up to OOP); $500 max/script
Recovery/ Special Needs
Home Health Care	100% after deductible (up to OOP); 100 visits per year
Durable Medical Equipment	100% after deductible (up to OOP)

Optional Benefits	None

Complete Benefit Summary

If you you have questions about the Health Net Bronze 60 HSP plan or any other plans from Health Net of California please call The Lynn Company at (800)-326-5966 for more information on California Health Insurance Plans.

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Please note that we cannot bind insurance via email, fax, or voicemail. Any quotes given are subject to underwriting guidelines by the respective insurance carriers. Any reference of coverage used are not intended to express legal opinion as to the nature of coverage, but rather just a brief generalization of coverages. Please read your policy for coverage details.

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3761 Bernard Street | Bakersfield, CA 93306
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