Health Net vs Kaiser: Which One is Best in 2021?

Today we are going to show you core comparisons on Health Net vs Kaiser. If you read the whole article we believe you could make a proper decision regarding selecting suitable health insurance. Happy reading…

Health Net is a managed health care insurance provider in the United States. It is a Centene company headquartered in Los Angeles, California. The company provides behavioral health and substance abuse assistance along with managed health care products. Centene of St. Louis acquired Health Net for $6.8 billion in March 2016.

Kaiser Permanente is an American integrated managed care conglomerate founded in 1945. Founded by Henry J. Kaiser and Sidney Garfield, its headquarter is situated in Oakland, California. Kaiser Permanente consists of three separate but interdependent groups – Kaiser Foundation Health Plan, Inc. (KFHP), Kaiser Foundation Hospitals, and Permanente Medical Groups. It is the largest managed care organization in the United States.

Health Net vs Kaiser:

It is difficult to compare Health Net and Kaiser as they both go neck-to-neck in certain plans and market sections. Both Health Ne and Kaiser compete with each other in three big market sections –

  • Individual and Family
  • Small Business
  • Medicare Advantage and Supplement plans.

Kaiser HMO

Kaiser’s health insurance plans are all HMO-based. An HMO plan is less expensive but it limits your access to doctors and hospitals within the network. Kaiser owns the hospitals and employs the doctors, which means everything comes under one umbrella. All your medical records will be available to any doctor of Kaiser’s network making communication and coordination easier.

However, there is a drawback to Kaiser HMO. Since it’s an HMO plan, means you have to stay within the network. As a result, if you get to know a doctor or hospital who does better treatment than the Kaiser network, you won’t get coverage for that expense.

Health Net’s HMO

Health Net initially started with HMO; however, they focused more on PPO when HMO pricing went down. But till now HMO is Health Net’s main option. They make contracts with independent doctors, hospitals, labs, and medical groups. In this case, Health Net will pay a certain amount to a doctor or medical group for each of their HMO members. In this case, you can get access to different doctors and hospitals.

Health Net’s PPO

Health Net also provides a Preferred Provider Organisation or PPO plan. With this plan, you can get access to healthcare professionals and facilities outside the Health Net network. However, your expense will increase, as the coverage amount will be less compared to an HMO plan.

Individual and Family

Both Health Net and Kaiser participate in the Covered California market offering ACA health plans. They have the lowest HMO pricing available in the market. Their competitors can be LA Care, Western Health Advantage, and Molina if available in your region. When you compare Kaiser and Health Net’s HMO plans, you can see that they will have a 10% price range difference between them.

Many people also opt for PPO or EPO plans for their benefits. Health Net offers both PPO and EPO plans. But people tend to choose Anthem Blue Cross or Blue Shield of California for PPO because of the pricing and bigger networks.

Small Business

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%. In the small business market, Kaiser leads the way with its PPO pricing for other PPO and HMO plans. Because of their pricing, many employers offer Kaiser PPO to their employees. However, Health Net beats Kaiser in the group market with its narrow HMO network. But again, whichever company has the stronger network in your area, you should go for that one. Kaiser allows other network members to enroll with themselves.

Medicare Plans

Both Health Net and Kaiser are very aggressive in the Medicare market. Since Kaiser is an HMO carrier, it fully invests in the Medicare Advantage market. On the other hand, Health Net being both HMP and PPO offers both Medicare Advantage and Medicare Supplement plans. Again, it is your decision based on network and pricing which provider you will opt for.

When it comes to choosing Kaiser, you need to think if you want to stay within the Kaiser network. In the case of Health Net HMO, you need to consider the doctors, whereas, with PPO, it is all about the doctors and health care decisions.

Frequently Asked Questions

  • What is the difference between Kaiser HMO and PPO?

You should select Kaiser HMO and PPO plans based on the most important factor – cost or flexibility. Kaiser HMO plans are less expensive which you can consider if the cost is more important to you. In such a case you have to stay within the network.

A PPO plan is more expensive than HMO plans. However, you have the option to see doctors outside the provider network. Moreover, if you have more confusion then we will suggest you read the above Health Net vs Kaiser information to know more facilities.

  • Is Health Net PPO or HMO?

Health Net offers both HMO and PPO plans. Health Net of California, Inc. offers HMO and HSP plans, while PPOs and EPOs are offered by Health Net Life Insurance Company. You have a primary care physician in an HMO plan who deals with all your medical care. If you want to see another doctor, you need to take a reference from your primary physician.

You may also like: