Medicare AdvantageAdministrativeMedium impact
21-759 Introducing Wellcare By Health Net’s New Medicare PPO
Health Net·CA·Prior Authorization
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Health Net is launching a new Medicare PPO called Wellcare No Premium Open (PPO) effective January 1, 2022, in Amador and Sutter counties. Providers must follow Health Net's prior authorization requirements, submit claims through Health Net systems, and verify member eligibility before appointments.
Action Required
Immediately: Billing team must update systems to recognize Wellcare No Premium Open (PPO) members in Amador and Sutter counties. Verify eligibility before each appointment using Health Net's provider portal at provider.healthnet.com or call 800-275-4737. Submit claims electronically via clearinghouse or Health Net's portal, or mail paper CMS-1500 forms to Health Net Medicare Claims, PO Box 9030, Farmington, MO 63640-9030. Providers must check prior authorization requirements through Health Net's portal under Medicare Plans section before services.