In the event, you needed to seek medical care before you received your insurance ID cards from as an enrolled Health Net member, you will be able to file a claim if you paid out-of-pocket for the medical services rendered.
If approved, your claim will only reimburse the amount that Health Net would have covered as the benefit.
To submit a claim:
- Complete one of the claim forms below:
- Prescription Claim Form
- Medical Claim Form
- Vision Out-of-State Claim Form
- Obtain a copy of an itemized bill that includes diagnosis codes
- Copy of the receipt, showing the amount you paid
- Complete the HIPPA form
- Mail all the documents to the address listed on the claim form.
Prescription Claim Form Eng
Prescription Claim Form Esp
Medical Claim Form Eng
Medical Claim Form Esp
Vision Out-of-State Claim Form
Foreign Claim QNR Eng
Foreign Claim QNR Esp
Explanation of Benefits Document
After you use your Health Net benefits, you may receive a document called an Explanation of Benefits, also known as the EOB. This document is not a bill, but a detailed description of the services you received and the relative cost. To view a descriptive sample that can assit you in understanding this document, please click below:
Understanding your EOB
You can access your health plan information (such as ID cards, copays, deductible info, etc) with Health Net by using their mobile friendly site. Click below for further details or visit www.healthnet.com/mobile:
Health Net Mobile
Healthnet customer service
If you have questions relating to your EOB or to a recent claim that was submitted to Health Net, please call the Health Net customer service department at 1-800-522-0088.