Dependent Plan Details

Benefit Documents - Academic Year 2022-2023

• 2022-2023 Summary of Benefits Booklet (PDF)
• 2022-2023 Summary of Benefits and Coverage (SBC) (PDF)

Dental and Vision Care Options

If you or your covered dependents are under the age of 19, you are automatically enrolled in Health Net's Pediatric Dental and Vision coverage. Get more detailed information:

• Pediatric Dental – Member Letter (PDF)
• Pediatric Dental and Vision Flyer (PDF)

Pharmacy Benefits

Purchase prescription drugs at any participating Health Net pharmacy nationwide.

Prescription drug formulary (PDF)

Cost-Saving Tips:

• See in-network providers and save on out-of-pocket costs
• Choose generic prescription drugs instead of brand-name
• Use the mail order pharmacy program and save one copay