04 Nov 2014

Health Net Slashes the Number of Providers Available in Covered CA Plans

04 Nov 2014

Although Health Net will not release their new EPO network provider list to the public until they receive regulatory approval, we have heard from insiders that the following key medical groups and facilities will NOT be part of Health Net’s EPO network in 2015:

  • UC Medical Groups
  • Palo Alto Medical Foundation, PAMF – Mills Peninsula Medical Group
  • Sutter Health and Sutter Health Affiliates
  • Brown and Toland Medical Group
  • California Pacific Medical Center (CPMC)

Note that consumers who purchase a Health Net plan directly in 2015 will get access to their full PPO network, but those who purchase individual plans through Covered CA will only get access to a very limited EPO network in Northern California.  Small businesses purchasing coverage through the Covered CA SHOP will have access to both Health Net EPO and some PPO plans.

Our frank assessment of this news is that there is no possible reason to choose Health Net if you are are Northern California resident purchasing coverage through the Covered California exchange.  Anthem and Blue Shield both have their network limitations, but both will offer larger networks and more choice than Health Net, and at lower rates in 2015.

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  1. Sandy Shaw January 3rd, 2015 9:37AM

    Wish I would have read this articles, which came out a few days before I signed up for Health Net through Covered California for 1/1/15. When I signed up for my EPO I made sure it had specific doctors, CPMC, and Sutter because of an upcoming surgery I was to have. I recently discovered the plan now does not include CPMC or Sutter, and my primary care physician (one of the first things I checked) isn’t even in my network any more! This was really a bait-and-switch by Health Net. Feel totally screwed, especially since I was conned into a more expensive plan thinking I was getting a broader range of providers when I am getting less. If anyone is bringing a class-action suit against Health Net. I’m in!

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