ValueNet – Health Net California – California

A comparison of the ValueNet offered by Health Net California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network

Copay	$35 copay (deductible waived for first 2 visits), additional visits subject to deductible and coinsurance	50%
OfficeVisit	$35 copay (deductible waived for first 2 visits of any combination of professional services and preventive care), additional visits- 65% after deductible	50%
Deductible
Coinsurance	65%	50%
Coinsurance Limit	See OOP	See OOP
Out-of-Pocket Maximum
Lifetime Maximum	Unlimited	Unlimited
Prescription Drugs	Generic Only- $10 copay	Generic Only- $10 copay
Emergency Room	65%	65%
Adult Preventative Care	Covered in full (deductible waived)	Not covered
Child Preventative Care	Covered in full (deductible waived)	Not covered
Lab / X-Ray	65%	50%
Maternity	Not covered	Not covered
Physical Therapy	Outpatient rehabilitative therapy (includes physical, speech, occupational, respiratory and cardiac therapy): 65%	Outpatient rehabilitative therapy (includes physical, speech, occupational, respiratory and cardiac therapy): 50%
Home Health Care
Mental Health	Mental health for non-severe conditions: 65%	Mental health for non-severe conditions: 50%
Hospital Care	Inpatient, semiprivate hospital room or intensive care unit with ancillary services (unlimited, except for non-severe mental health and substance abuse treatment. Out-of-network maximum allowable charges are $600 per day.): 65%	Inpatient, semiprivate hospital room or intensive care unit with ancillary services (unlimited, except for non-severe mental health and substance abuse treatment. Out-of-network maximum allowable charges are $600 per day.): 50%