Description / Exclusions / Application (select Coverage Type: Short Term
When you need health coverage, you can count on Health Net.
COMPREHENSIVE CARE
When you enroll in Quick Net, you select the
health plan that fits your needs. After you meet
your plan deductible, you have coverage for
doctor office visits, inpatient hospital care,
outpatient surgery, emergency room coverage,
prescription drugs, and more1.
CHOOSE YOUR DOCTOR
Quick Net from Health Net is a PPO (preferred
provider organization). Receive benefits when
you seek care from health care providers who
are on our PPO network list. Or, pay a little
more to see licensed physicians who are not on
our list. The choice is yours.
QUICK NET BENEFITS AT A GLANCE
PPO Network |
Out-of-Network |
PPO Network |
Out-of-Network |
PPO Network |
Out-of-Network |
|
| Deductible | $500 |
$1,000 |
$1,000 |
$1,500 |
$2,500 |
$3,000 |
| Lifetime maximum | $1 million |
$1 million |
$1 million |
|||
| Out-of-Pocket maximum | $1,500 |
$3,000 |
$2,000 |
$4,000 |
$3,000 |
$6,000 |
| Office Visits | 20% |
50% MAA |
25% |
50% MAA |
30% |
50% MAA |
| Urgent care | 30% |
50% MAA |
30% |
50% MAA |
30% |
50% MAA |
| Diagnostic X-ray/EKG/Ultrasound | 30% |
50% MAA |
30% |
50% MAA |
30% |
50% MAA |
| Diagnostic laboratory tests | 30% |
50% MAA |
30% |
50% MAA |
30% |
50% MAA |
| CT/MRI/PET/SPECT/EEG/Holter monitor/stress test | 30% |
50% MAA |
30% |
50% MAA |
30% |
50% MAA |
| Inpatient hospital care | 20% |
50% MAA |
25% |
50% MAA |
30% |
50% MAA |
| Emergency room care | 30% |
50% MAA |
30% |
50% MAA |
30% |
50% MAA |
| Prescription coverage | $250 deductible |
$250 deductible |
$250 deductible |
|||
| Preferred Generic - Tier 1 | $15 |
$15 |
$15 |
|||
| Preferred Generic - Tier 2 | $30 |
$30 |
$30 |
|||
| Non-Preferred Brand - Tier 3 | You pay 100%4 |
You pay 100%4 |
You pay 100%4 |
|||
| Specialty Pharmacy - Special Rx | You pay 100%4 |
You pay 100%4 |
You pay 100%4 |
|||
| Prescription Benefit Maximum | $1,000 |
$1,000 |
$1,000 |
|||
4) You pay the full cost of the prescription at Health Net’s discounted rate.
Maximum Allowable Amount (MAA) will apply to out-ofnetwork providers.
BRIEF SUMMARY OF COVERED BENEFITS
- Physician office visits, including specialist consultations
- Neuromuscular rehabilitation
- Durable medical equipment
- Inpatient hospital care
- Outpatient surgery
- Emergency room
- Home health care
- Outpatient infusion therapy
- Prescription drugs
