Health Insurance Product Reviews (BETA)
Major Carriers and High Deductible Health Plans

Vimo Editorial: Health Plan Profile

Health Net offers three SimpleValue plans which only differ in the amount they require you to pay as a copayment for a doctor's office visit -- $30, $40 or $50 – and the coinsurance amounts – 30%, 40%, or 50%.

It's a simple way of differentiating the plans, and it's pretty obvious which one will have the lowest premium: the one with the highest coinsurance and highest copayment.

These plans also have no annual deductible, so you enjoy benefits from them the moment you need medical care. But for inpatient hospital service and outpatient surgical facilities, there is a $400 per day admission fee, which you are only required to pay for a maximum of four days per stay.

While there's no deductible, there is a coinsurance maximum of $7,500 for in-network providers, or $10,000 for out-of-network providers. Two different types of prescription drug options are available: generic only ($10 copay) or a combo option that provides a generic drug benefit ($10 copay) and a brand-name benefit ($35 copay), with a separate annual deductible of $750 for brand name drugs.

BEST FOR: Someone looking for an inexpensive, easy-to-understand, flexible health plan that delivers benefits to the carrier immediately. Some plans force you to burn through a costly deductible before the plan shells out one penny for you. This plan gives you benefits right away.

PROS: Simplicity and flexibility. Low premiums. Plus, Health Net has an excellent network.

CONS: The limits of any low-cost plan. This one does not have maternity coverage and you will pay a high out-of-pocket maximum in the event of a major medical emergency.