Ambetter HMO
HMO members use the Ambetter HMO network and a primary care physician. Referrals are generally required for specialists, with stated exceptions and emergency or approved care.
Individual health carrier | 2026
Health Net Ambetter Individual and Family Plans
Ambetter HMO and PPO individual plans with online member tools, pharmacy benefits, wellness resources, and preventive care guidance.
2026 plan guide
How the coverage is structured
Health Net's Ambetter HMO and PPO plans share member tools and pharmacy resources but differ in referrals and non-network coverage. Start by matching the network model to how your household receives care.
Ambetter PPO
PPO members may see specialists without a PCP referral and can use non-network providers. Non-network care generally costs more and may create balance-billing exposure.
Benefits and cost sharing
The Plan Contract, Evidence of Coverage, and Summary of Benefits and Coverage explain deductibles, copays, coinsurance, prior authorization, and the services covered by a specific plan.
Prescriptions and wellness
Members should review the current Essential Drug List and pharmacy network. Health Net materials also describe digital mental health, coaching, and wellness resources.
Before and after enrollment
Using the plan with fewer surprises
Health Net's 2026 quick-start guides organize the first steps for using coverage, from finding care and creating an account to filling prescriptions and keeping premiums current.
Find network care
Use the applicable Ambetter HMO or PPO provider directory. HMO and PPO networks are not interchangeable, even when the carrier name is the same.
Create the member account
The online account supports temporary ID cards, payments, provider searches, PCP changes, and benefit and pharmacy information.
Know where to go for care
Review when to use primary care, urgent care, behavioral health, virtual care, or emergency services, and understand the referral rules for the selected plan.
Keep coverage active
Pay the monthly premium by the due date and contact Covered California when marketplace household, income, address, or coverage information changes.
Official source documents
Review the carrier materials
These PDFs provide additional detail from the carrier. They open in a new tab and should be read with the current Evidence of Coverage and Summary of Benefits and Coverage for the plan you select.
Before you enroll
Plan availability and benefits can change.
This page summarizes carrier materials for the 2026 plan year. It is not a policy, contract, quote, or guarantee of eligibility or benefits. The current carrier application, Evidence of Coverage, Summary of Benefits and Coverage, provider directory, and formulary control.
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