Today we want to show the best comparison on Health Net Vs Blue Shield of California. We collected reliable information from the website and direct contact with the authorities. We believe this information will help you to get a perfect health insurance company for your health security.
Health Net is a US-based managed health care insurance provider. It is a Centene company with headquarter in Los Angeles, California. The company’s subsidiaries provide behavioral health and substance abuse assistance along with managed health care products. St. Louis-based Centene acquired Health Net for $6.8 billion in March 2016.
Blue Shield of California is a non-profit health plan provider based in Oakland, California. Founded in 1939, Blue Shield serves more than 4 million members and has around 65,000 physicians throughout the state. It was founded by the California Medical Association as a not-for-profit organization. The California Franchise Tax Board removed the tax-exempt status of Blue Shield of California in 2014.
Health Net Vs Blue Shield of California:
Both Health Net and Blue Shield made their place in the top 5 insurance carriers in California. They can be compared based on the following three markets in California –
- Individual and Family
- Small Business
- Medicare Advantage and Supplement plans
Health Net of California
Health Net operated as an HMO dominant career at the starting of their journey. Later they started adding PPOs to their range of plans. Now they are present in all the important markets of California –
- Individual Family – HMO’s, PPO’s, HSA’s and PPO’s
- Small Business – HMO, PPO, HSA’s, EPO”s, HRA’s
- Medicare – Supplemental plans, Advantage plans
- Dental, vision, life
- Covered California – Individual/Family and Small Group
Blue Shield of California
Blue Shield of California did not function effectively at the beginning. However, they have changed over the last decade. It was always a competitor of the Anthem Blue Cross and Kaiser in the Californian market. Blue Shield is also present in all the major markets of California –
- Individual and Family
- Small business health plans
- Senior plans – Medicare Advantage and Medicare Supplement plans
- Dental, vision, life
- Adopted Covered California
When it comes to the provider network, Health Net has HMO while Blue Shield of California has both HMOs and PPOs. HMO plans limits your access to healthcare professionals and facilities within the network. Whereas PPO plans let you see doctors out of their network. Health Net’s HMO plans are typically lower than Blue Shield. Blue Shield focuses more on PPO plans. In such a case, your expenses will increase as you can access out-of-network health care facilities. But you will have a wide range of choices. Hence, in the Covered California market, it is your decision to choose between HMO and PPO plans.
Individual and Family
As mentioned earlier, Health Net mostly focuses on HMO in many markets, especially in the more populous regions. Meanwhile, Blue Shield tends to focus on PPO. However, choosing a network does not end your job for selecting a plan. You have to consider the pricing of individual plans as well. HMO plans are less expensive than PPO plans, but monthly premiums and doctor visit fees may differ in different areas. So you need to reconsider the network and pricing of individual plans before opting for any.
The Small Business market generally comprises 1-100 employees. The employer will choose a plan for them. According to the ACA law, all plans must meet some benefit levels like Bronze, Silver, Gold, and Platinum. A certain plan should meet one of these four levels by +/- 2%. Both the Health Net and Blue Shield of California are very efficient in the Small Business market. Their pricings are almost neck-to-neck in comparison. Employers generally offer HMO, PPO, HSA, etc. plans to their employees.
Since pricings are almost similar, it is now time to choose the network. Most employees opt for HMO or PPO plans. However, in the Covered California market, the list of HMO providers is around 2/3rd of the PPO list. Both Health Net and Blue Shield of California offer coverage for dental, vision, life, and much more.
Medicare Advantage and Supplement Plans of AARP and Anthem Blue Cross
AARP and Anthem Blue Cross used to dominate the Senior market in California before. Then Blue Shield became aggressive in the plans for the senior citizens of age 65 years and above. Soon Health Net followed their step and now they are the two leading providers in the Medicare Advantage and Medicare Supplement market. In the Medicare market, both companies have similar plans with different products and standardized benefits.
Both Health Net and Blue Shield of California are the strongest providers in the Covered California market. Blue Shield is a non-profit organization while Health Net is a publicly-traded company. Health Net is hard to beat in its HMO network, whereas Blue Shield is the strongest in the PPO network. Therefore, it is your decision which one you will prefer over the other – network or pricing.
Frequently Asked Questions
- Is Health Net PPO or HMO?
Health Net of California, Inc. offers HMO and HSP plans. Meanwhile, PPOs and EPOs are offered by Health Net Life Insurance Company. An HMO plan offers you a primary care physician who looks after all your medical needs. In case if you need to see another doctor, you need to take a reference of your primary physician.
- What is Blue Shield Trio HMO?
The Trio HMO plan is a new addition in the Accountable Care Organisation (ACO). It is both affordable and predictable with low copays and no deductibles. This plan gives you access to a quality network of local health care professionals and hospitals. However, you must have a primary care physician who will coordinate all your care.
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