NCS
Health Net of California — Basic Option
FEHB Not offered after 2026|Health Net of California (Southern Region)|Traditional|HMO
Premium
biweekly · employee paysSelf Only 2026
$79.71biweekly · employee pays
vs 2025+$13.56 +20.5%
Lowest$33.20 (2016)
Highest$79.71 (2026)
Since 2016+140.1%
Self Plus One 2026
$175.37biweekly · employee pays
vs 2025+$29.83 +20.5%
Lowest$73.04 (2016)
Highest$175.37 (2026)
Since 2016+140.1%
Self & Family 2026
$191.31biweekly · employee pays
vs 2025+$32.54 +20.5%
Lowest$79.68 (2016)
Highest$191.31 (2026)
Since 2016+140.1%
Premium history
SharePeriodRate type
Year by year
follows the chart's share, period and rate-type selection| Year | Self Only | Δ | Self Plus One | Δ | Self & Family | Δ | Listed as |
|---|
Changelog
- 2016First appears in OPM rate tablesNew plan option for 2016.
- 2020Largest decrease: -2.4%Self Only employee share went from $38.35 to $37.43.
- 2025Largest increase: +24.2%Self Only employee share went from $53.24 to $66.15.
- 2027No longer offeredNot present in OPM rate tables for 2027.
Full rate schedule
Plan yearIn-network
2026 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | Not applicable | Not applicable | Not applicable |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | Not applicable | Not applicable | Not applicable |
| Annual out-of-pocket maximum | $4,500 | $9,000 | $9,000 |
- Type of accountNot Applicable
- Deductible waiver (with Medicare Part A as Primary)Not applicable
- Deductible waiver (with Medicare Part B as Primary)Not applicable
- Deductible waiver (with Medicare Parts A and B as Primary)Not applicable
- Out-of-pocket maximum (with Medicare Parts A and B as Primary)$4,500
- Primary care physician office visit (with Medicare Part B as Primary)$40 Copayment
- Specialty office physician visit (with Medicare Part B as Primary)$40 Copayment
- Inpatient Hospital Services (with Medicare Part A as Primary)$500 Copayment
- Outpatient hospital services (with Medicare Part A as Primary)$500 Copayment
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement (with Medicare as Primary)No
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver (with Medicare Advantage Part C as Primary)Not applicable
- Out-of-Pocket Maximum (with Medicare Advantage Part C as Primary)Not applicable
- Primary Care Physician Office Visit (with Medicare Advantage Part C as Primary)Not applicable
- Specialty Physician Office Visit (with Medicare Advantage Part C as Primary)Not applicable
- Inpatient Hospital Services (with Medicare Advantage Part C as Primary)Not applicable
- Outpatient Hospital Facility Services (with Medicare Advantage Part C as Primary)Not applicable
- Outpatient physician services (with Medicare Advantage Part C as Primary)Not applicable
- Part B Premium Reimbursement (with Medicare Advantage Part C as Primary)No
- Medicare Part D EGWP Prescription Drug Deductible WaiverNot applicable
- Medicare Part D EGWP Prescription Drug Out-of-Pocket MaximumNot applicable
- Medicare Part D EGWP Tier 0Not applicable
- Medicare Part D EGWP Tier 1Not applicable
- Medicare Part D EGWP Tier 2Not applicable
- Medicare Part D EGWP Tier 3Not applicable
- Medicare Part D EGWP Tier 4Not applicable
- Medicare Part D EGWP Tier 5Not applicable
- Medicare Part D EGWP Tier 6Not applicable
- Preventive CareMember Pays Nothing
- Primary Care Office Visit$40 Copayment
- Specialist Office Visit$40 Copayment
- Emergency Care$100 Copayment
- Urgent Care$40 Copayment
- Doctor Costs for Inpatient SurgeryMember Pays Nothing
- Hospital Inpatient Cost Per Admission$500 Copayment
- Hospital Room Costs$500 Copayment
- Other Inpatient Hospital Costs$500 Copayment
- Doctor Costs for Outpatient SurgeryMember Pays Nothing
- Other Outpatient Surgery Costs$500 Copayment
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)Member Pays Nothing
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)Member Pays Nothing
- Enhanced Lab NetworkMember Pays All Charges
- Annual Out-of-Pocket Maximum for Prescriptions$2,000
- Tier 0Not applicable
- Tier 1$15 Copayment
- Tier 2$35 Copayment
- Tier 3$65 Copayment
- Tier 420% Coinsurance
- Tier 5Not applicable
- Tier 6Not applicable
- Mail Service Pharmacy Benefit (Prescription Drugs)Yes
- Mail Order Pharmacy Restriction (Prescription Drugs)Yes
- Specialty Pharmacy Restriction (Prescription Drugs)Yes
- Applied Behavioral Analysis (ABA)Member Pays Nothing
- Chiropractic$10 Copayment
- Occupational Therapy$40 Copayment
- Physical Therapy$40 Copayment
- Speech Therapy$40 Copayment
- Professional Services (Mental Health and Substance Use Disorder)$40 Copayment
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)$500 Copayment
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays Nothing
- Diagnosis and Treatment (Infertility Services)$40 Copayment
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)$40 Copayment
- Artificial Insemination Services (e.g. ICI, IVI, IUI)$40 Copayment
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)$40 Copayment
- Surgical Procedures$500 Copayment
- Reconstructive Surgery$500 Copayment
- Hearing Services$40 Copayment
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)$40 Copayment
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)$500 Copayment
- Hospice CareMember Pays Nothing
- Home Health Services (Skilled Nursing Care)$40 Copayment
- Durable Medical EquipmentMember Pays Nothing
- Outpatient Rehabilitation (Skilled Nursing Care Facility)$25 Copayment
- Diabetes EducationMember Pays Nothing
- Nutritional CounselingMember Pays Nothing
- Routine Dental Exams and Cleaning for AdultsNot Covered
- Routine Dental Exams and Cleaning for ChildrenNot Covered
- Routine Eye ExamsCovered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- Acupuncture$10 Copayment
- Chronic Disease Management: Heart DiseaseCovered
- Chronic Disease Management: ObesityCovered
- Chronic Disease Management: HypertensionCovered
- Chronic Disease Management: AsthmaCovered
Out-of-network
2026 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | Not applicable | Not applicable | Not applicable |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | Not applicable | Not applicable | Not applicable |
| Annual out-of-pocket maximum | Not applicable | Not applicable | Not applicable |
- Type of accountNot Applicable
- Deductible waiver (with Medicare Part A as Primary)Not applicable
- Deductible waiver (with Medicare Part B as Primary)Not applicable
- Deductible waiver (with Medicare Parts A and B as Primary)Not applicable
- Out-of-pocket maximum (with Medicare Parts A and B as Primary)Not applicable
- Primary care physician office visit (with Medicare Part B as Primary)Member Pays All Charges
- Specialty office physician visit (with Medicare Part B as Primary)Member Pays All Charges
- Inpatient Hospital Services (with Medicare Part A as Primary)Member Pays All Charges
- Outpatient hospital services (with Medicare Part A as Primary)Member Pays All Charges
- Outpatient physician services (with Medicare Part B as Primary)Member Pays All Charges
- Part B Premium Reimbursement (with Medicare as Primary)Not applicable
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver (with Medicare Advantage Part C as Primary)Not applicable
- Out-of-Pocket Maximum (with Medicare Advantage Part C as Primary)Not applicable
- Primary Care Physician Office Visit (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Specialty Physician Office Visit (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Inpatient Hospital Services (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Outpatient Hospital Facility Services (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays All Charges
- Part B Premium Reimbursement (with Medicare Advantage Part C as Primary)Not applicable
- Medicare Part D EGWP Prescription Drug Deductible WaiverNot applicable
- Medicare Part D EGWP Prescription Drug Out-of-Pocket MaximumNot applicable
- Medicare Part D EGWP Tier 0Member Pays Nothing
- Medicare Part D EGWP Tier 1Member Pays Nothing
- Medicare Part D EGWP Tier 2Member Pays Nothing
- Medicare Part D EGWP Tier 3Member Pays Nothing
- Medicare Part D EGWP Tier 4Member Pays Nothing
- Medicare Part D EGWP Tier 5Member Pays Nothing
- Medicare Part D EGWP Tier 6Member Pays Nothing
- Preventive CareMember Pays All Charges
- Primary Care Office VisitMember Pays All Charges
- Specialist Office VisitMember Pays All Charges
- Emergency Care$100 Copayment
- Urgent Care$40 Copayment
- Doctor Costs for Inpatient SurgeryMember Pays All Charges
- Hospital Inpatient Cost Per AdmissionMember Pays All Charges
- Hospital Room CostsMember Pays All Charges
- Other Inpatient Hospital CostsMember Pays All Charges
- Doctor Costs for Outpatient SurgeryMember Pays All Charges
- Other Outpatient Surgery CostsMember Pays All Charges
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)Member Pays All Charges
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)Member Pays All Charges
- Enhanced Lab NetworkMember Pays All Charges
- Annual Out-of-Pocket Maximum for PrescriptionsNot applicable
- Tier 0Not applicable
- Tier 1Not applicable
- Tier 2Not applicable
- Tier 3Not applicable
- Tier 4Not applicable
- Tier 5Not applicable
- Tier 6Not applicable
- Mail Service Pharmacy Benefit (Prescription Drugs)Not applicable
- Mail Order Pharmacy Restriction (Prescription Drugs)Not applicable
- Specialty Pharmacy Restriction (Prescription Drugs)Not applicable
- Applied Behavioral Analysis (ABA)Member Pays All Charges
- ChiropracticMember Pays All Charges
- Occupational TherapyMember Pays All Charges
- Physical TherapyMember Pays All Charges
- Speech TherapyMember Pays All Charges
- Professional Services (Mental Health and Substance Use Disorder)Member Pays All Charges
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays All Charges
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays All Charges
- Diagnosis and Treatment (Infertility Services)Member Pays All Charges
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)Member Pays All Charges
- Artificial Insemination Services (e.g. ICI, IVI, IUI)Member Pays All Charges
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical ProceduresMember Pays All Charges
- Reconstructive SurgeryMember Pays All Charges
- Hearing ServicesMember Pays All Charges
- Hearing Aids (external)Not Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)Member Pays All Charges
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)Member Pays All Charges
- Hospice CareMember Pays All Charges
- Home Health Services (Skilled Nursing Care)Member Pays All Charges
- Durable Medical EquipmentMember Pays All Charges
- Outpatient Rehabilitation (Skilled Nursing Care Facility)Member Pays All Charges
- Diabetes EducationMember Pays All Charges
- Nutritional CounselingMember Pays All Charges
- Routine Dental Exams and Cleaning for AdultsNot Covered
- Routine Dental Exams and Cleaning for ChildrenNot Covered
- Routine Eye ExamsNot Covered
- Eye Exams for Medical Condition or Non-Surgical TreatmentNot Covered
- EyeglassesNot Covered
- Contact LensesNot Covered
- AcupunctureMember Pays All Charges
- Chronic Disease Management: Heart DiseaseNot Covered
- Chronic Disease Management: ObesityNot Covered
- Chronic Disease Management: HypertensionNot Covered
- Chronic Disease Management: AsthmaNot Covered
States
1California
Counties covered
| State | Area |
|---|---|
| California | Los Angeles, Orange, Riverside, San Bernardino, San Diego |
Service area over time
| Year | States / areas listed |
|---|---|
| 2026 | California |
| 2025 | California |
| 2024 | California |
| 2023 | California |
| 2022 | California |
| 2021 | California |
| 2020 | California |
| 2019 | California |
| 2018 | California |
| 2017 | California |
| 2016 | California |