Health Net Vs Blue Shield of California

Health Net Vs Blue Shield of California: Which is Best in 2024?

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 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 headquarters in Los Angeles, California. The company’s subsidiaries provide behavioral health and substance abuse assistance and 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. The California Medical Association founded it 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 California’s top 5 insurance carriers. 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 start of their journey. Later they started adding PPOs to their range of plans. Now they are present in all the critical 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 an Anthem Blue Cross and Kaiser competitor 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

Network Strength

When it comes to the provider network, Health Net has HMO, while Blue Shield of California has both HMOs and PPOs. HMO plans limit your access to healthcare professionals and facilities within the network. At the same time, 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, you choose between HMO and PPO plans.

Individual and Family

As mentioned earlier, Health Net mainly focuses on HMO in many markets, especially in the more populated regions. Meanwhile, Blue Shield tends to concentrate on PPO. However, choosing a network does not end your job 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 it would help if you reconsidered the network and pricing of individual plans before opting for any.

Small Business

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 dental, vision, life, and much more coverage.

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 senior citizens of age 65 years and above plans. Soon Health Net followed their step, and now they are the two leading providers in the Medicare Advantage and Medicare Supplement market. Both companies have similar plans with different products and standardized benefits in the Medicare market.

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, you will decide 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 provided by Health Net Life Insurance Company. An HMO plan offers you a primary care physician who looks after all your medical needs. If you need to see another doctor, you need to take a reference from your primary physician.

  • What is Blue Shield Trio HMO?

The Trio HMO plan is a new addition to 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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