Health Net Medicare Advantage Plan Provider Directory

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Directorio de Proveedores de Planes Health Net Medicare Advantage HMO Este directorio proporciona una lista de los proveedores de la red de Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) y Health Net Healthy Heart (HMO). Corresponde a los condados de Alameda, Contra Costa, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano y Sonoma. Entra en vigencia a partir de septiembre de 2011. Es posible que se hayan agregado o eliminado algunos proveedores de nuestra red después de que se haya impreso este directorio. No garantizamos que todos los proveedores aún acepten afiliados nuevos. Para obtener la información más actualizada sobre los proveedores de la red de Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) y Health Net Healthy Heart (HMO) de su área, puede visitar www.healthnet.com, o bien, puede llamar a nuestro Departamento de Servicio al Cliente al 1-800-977-6738 (para posibles afiliados), o al 1-800-275-4737 (para afiliados a Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) o Health Net Healthy Heart (HMO)), los siete días de la semana, de 8:00 a.m. a 8:00 p.m. Los usuarios de TTY/TDD deben llamar al 1-800-929-9955. Health Net. Una organización de Medicare Advantage que tiene un contrato con Medicare. This information is available for free in other languages. Please contact our customer service number at 1-800‐275-4737 for additional information. Our hours of operation are 8:00 a.m. to 8:00 p.m., seven days a week. TTY/TDD users call 1-800-929-9955. Esta información está disponible en forma gratuita en otros idiomas. Comuníquese con el número de nuestro servicio al cliente al 1-800‐275-4737 para obtener información adicional. Nuestro horario de atención es de 8:00 a.m. a 8:00 p.m., los siete días de la semana. Los usuarios de TTY/TDD deben llamar al 1-800-929-9955. Este documento puede estar disponible en un formato diferente, como Braille, letra grande o audio. Comuníquese con el número de nuestro servicio al cliente al 1-800-275-4737 para obtener información adicional. Nuestro horario de atención es de 8:00 a.m. a 8:00 p.m., los siete días de la semana. Los usuarios de TTY/TDD deben llamar al 1-800-929-9955. N.° de Identificación del Material Y0035_2012_0301_SPN (H0562, H5439, H0351, H5520, H6815) File & Use 09172011
Section 1 – Introduction This directory provides a list of Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) and Health Net Healthy Heart (HMO)’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our network providers who are listed in this directory to be your Primary Care Physician (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care coverage from your PCP. As a member of Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) or Health Net Healthy Heart (HMO), you will have a PCP who coordinates all of your care. Your PCP is a health care professional who is trained to give you basic care. He or she is responsible for providing or coordinating covered services while you are a member of Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) or Health Net Healthy Heart (HMO). When you enroll in Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) or Health Net Healthy Heart (HMO), you will select a Health Net participating physician group from our network. You’ll also choose a PCP from this Health Net participating physician group. This Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) and Health Net Healthy Heart (HMO) participating physician directory is a list of all Health Net participating physician groups (and their PCP and hospital affiliations). As a Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO) or Health Net Healthy Heart (HMO) member, all of your routine health care is provided and arranged by your PCP. Your specialty care, X-rays, laboratory tests, therapy, prescription medications, hospital admissions and follow-up care will also be provided, authorized or coordinated by your PCP. If you go to a doctor, hospital or other provider without the approval of your PCP – except in an emergency or when you need urgent care, out-of-area renal dialysis, or certain gynecological care or other self-referred services – you will be responsible for paying any charges for these services. Neither Medicare nor Health Net will pay for non-emergency services or non-urgently needed care without the prior authorization of your PCP. 1
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PARTICIPATING PHYSICIAN GROUPS AND
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Physicians Medical Group of Santa C
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Sonoma County Primary Care IPA PPG
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Sutter East Bay Medical Foundation
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INDEX OF PARTICIPATING PHYSICIAN GR
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INDEX OF PRIMARY CARE PHYSICIANS AN
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INDEX OF HOSPITALS Hospitals Page V
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Health Net Medicare Advantage Plan Provider Directory

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