This plan generally replaces your Medicare coverage. You agree to let Health Net manage your Medicare benefits. It is an HMO (health maintenance organization) with a custom network of providers.

Plan changes

  • Prescription Drug Part D TrOOP (True Out-Of-Pocket) costs will increase from $4,950 to $5,000.
  • Copayments for certain services will increase slightly for low-income subsidy-eligible Medicare enrollees.
  • The network for Health Net Seniority Plus is expanding to include all of Placer County.
  • Health Net Seniority Plus members who are part of Sutter Medical Group will have access to behavioral health providers from MHN’s network only. These members previously utilized Sutter behavioral health providers.

How the plan works

  • You choose a primary care physician (PCP) who coordinates your care and refers you to specialists within your designated medical group.
  • You pay a small copayment for prescription drugs and some services.
  • The plan covers the cost of services only if your PCP authorizes them.
  • HMOs provide coverage for services outside of your medical group only in cases of emergency.
  • Health Net provides behavioral health services.
  • The Centers for Medicare and Medicaid Services must approve the service area for each Medicare plan. If your home zip code is outside of the Health Net Seniority Plus service areayou will not be eligible to enroll. Eligible zip codes can change throughout the year. Please contact the Retirement Administration Service Center, Health Net or Medicare.gov if you have a question about the eligibility of a particular zip code.

Best fit for you if:

  • You want lower out-of-pocket costs
  • You like having one doctor manage your care
  • You are comfortable with out-of-network coverage only in emergencies

Plan costs

Retiree plan costs chart »

Typical out-of-pocket costs

  • Office visit/urgent care visit: $20 (preventive care has no charge)
  • Emergency room: $65
  • Hospital stay: $250
  • Prescription drugs: $5 generic; $25 brand name; $40 non-formulary