For HMO Members
Plan	CMS#	County	Low Income Subsidy
Health Net Gold Select (HMO)	H0562 - 101-001	Los Angeles & Orange	Low Income Subsidy, H0562 - 101-001 - English (PDF) Low Income Subsidy, H0562 - 101-001 - Spanish (PDF)
Health Net Gold Select (HMO)	H0562 - 101-002	Riverside, San Bernardino	Low Income Subsidy, H0562 - 101-002 - English (PDF) Low Income Subsidy, H0562 - 101-002 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 068	Alameda & Stanislaus	Low Income Subsidy, H0562 - 068 - English (PDF) Low Income Subsidy, H0562 - 068 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 090	Fresno	Low Income Subsidy, H0562 - 090 - English (PDF) Low Income Subsidy, H0562 - 090 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 100-001	Los Angeles & Orange	Low Income Subsidy, H0562 - 100-001 - English (PDF) Low Income Subsidy, H0562 - 100-001 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 100-002	Riverside & San Bernardino	Low Income Subsidy, H0562 - 100-002 - English (PDF) Low Income Subsidy, H0562 - 100-002 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 012	San Diego	Low Income Subsidy, H0562 - 012 - English (PDF) Low Income Subsidy, H0562 - 012 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 009	San Francisco	Low Income Subsidy, H0562 - 009 - English (PDF) Low Income Subsidy, H0562 - 009 - Chinese (PDF)
Health Net Healthy Heart (HMO)	H0562 - 039	Yolo	Low Income Subsidy, H0562 - 039 - English (PDF) Low Income Subsidy, H0562 - 039 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 084	Placer, Sacramento	Low Income Subsidy, H0562 - 084 - English (PDF)
Health Net Seniority Plus Ruby (HMO)	H0562 - 079	Kern	Low Income Subsidy, H0562 - 079 - English (PDF) Low Income Subsidy, H0562 - 079 - Spanish (PDF)
Health Net Ruby Select (HMO)	H0562 - 097	San Francisco	Low Income Subsidy, H0562 - 097 - English (PDF) Low Income Subsidy, H0562 - 097 - Chinese (PDF)
Health Net Ruby Select (HMO)	H0562 - 112	Fresno	Low Income Subsidy, H0562 - 112 - English (PDF) Low Income Subsidy, H0562 - 112 - Spanish (PDF)
Health Net Ruby Select (HMO)	H0562 - 113	Alameda	Low Income Subsidy, H0562 - 113 - English (PDF) Low Income Subsidy, H0562 - 113 - Spanish (PDF) Low Income Subsidy, H0562 - 113 - Chinese (PDF)
Health Net Ruby Select (HMO)	H0562 - 103	Yolo	Low Income Subsidy, H0562 - 103 - English (PDF) Low Income Subsidy, H0562 - 103 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 119	Imperial	Low Income Subsidy, H0562 - 119 - English (PDF) Low Income Subsidy, H0562-119 - Spanish (PDF) Low Income Subsidy, H0562-119- Chinese (PDF)
Health Net Healthy Heart (HMO)	H0562 - 120	Santa Clara and Stanislaus	Low Income Subsidy, H0562 - 120 - English (PDF) Low Income Subsidy, H0562 - 120 - Spanish (PDF)
Health Net Seniority Plus Sapphire (HMO)	H0562 - 122	Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, Santa Clara and Stanislaus	Low Income Subsidy, H0562 - 122 - English (PDF) Low Income Subsidy, H0562 - 122 - Spanish (PDF)
Health Net Seniority Plus Sapphire Premier (HMO)	H3561 - 002	Alameda, Fresno, Kern, Los Angeles, Orange, San Diego,San Francisco & Tulare	Low Income Subsidy, H3561 - 002 - English (PDF) Low Income Subsidy, H3561 - 002 - Spanish (PDF) Low Income Subsidy, H3561 - 002 - Chinese (PDF)
Health Net Seniority Plus Sapphire Premier (HMO)	H3561 - 004	Imperial, Riverside & San Bernardino	Low Income Subsidy, H3561 - 004 - English (PDF) Low Income Subsidy, H3561 - 004 - Spanish (PDF)
Health Net Seniority Plus Sapphire Premier II (HMO)	H3561 - 005	Alameda, Fresno, Kern, Los Angeles, Orange, San Diego, San Francisco and Tulare	Low Income Subsidy, H3561 - 005 - English (PDF) Low Income Subsidy, H3561 - 005 - Spanish (PDF) Low Income Subsidy, H3561 - 005 - Chinese (PDF)
Health Net Seniority Plus Sapphire Premier II (HMO)	H3561 - 006	Imperial, Riverside, and San Bernardino	Low Income Subsidy, H3561 - 006 - English (PDF) Low Income Subsidy, H3561 - 006 - Spanish (PDF)

For HMO SNP Members
Plans	CMS#	County	Low Income Subsidy
Health Net Seniority Plus Amber I (HMO D-SNP)	H0562 - 055	Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco & Tulare	Low Income Subsidy, H0562 - 055 - English (PDF) Low Income Subsidy, H0562 - 055 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 117	San Francisco	Low Income Subsidy, H0562 - 117 - English (PDF) Low Income Subsidy, H0562 - 117 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 118	Fresno	Low Income Subsidy, H0562 - 118 - English (PDF) Low Income Subsidy, H0562 - 118 - Spanish (PDF)
Health Net Seniority Plus Amber II (HMO D-SNP)	H0562 - 121	Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco and Tulane	Low Income Subsidy, H0562 - 121 - English (PDF) Low Income Subsidy, H0562 - 121 - Spanish (PDF)
Health Net Seniority Plus Amber II Premier (HMO D-SNP)	H3561 - 001	Fresno	Low Income Subsidy, H3561 - 001 - English (PDF) Low Income Subsidy, H3561 - 001 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 092	Kern, Los Angeles & Orange	Low Income Subsidy, H0562 - 092 - English (PDF) Low Income Subsidy, H0562 - 092 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 114	San Diego	Low Income Subsidy, H0562 - 114 - English (PDF) Low Income Subsidy, H0562 - 114 - Spanish (PDF)

Extra Help with Medicare

The Medicare Extra Help program is for anyone that has Medicare and Medicare Prescription Drug (Part D) coverage, but have limited income and resources such as savings and stocks. This does not include your home or car.

What does Medicare Extra Help cover?

The Extra Help program can save you up to $5,000 each year. Many people qualify for this savings but don’t know it.

If you qualify for the Extra Help program, you will get help paying for Medicare prescription drug costs that is a part of your Part D coverage such as your monthly premium, yearly deductible, prescription co-payments and coinsurance. This Extra Help also counts toward your out-of-pocket costs.

See if You Qualify for Extra Help

Some people automatically qualify for the Extra Help program and don't need to apply. Medicare will mail you a letter if you automatically qualify for Extra Help.

Your income and resources can change from year to year, so check to see if you qualify for the program if you didn’t receive a letter from Medicare or were previously denied for the Extra Help program.

Apply for Extra Help

Applying for Extra Help is easy. Just complete the Social Security’s application for the Medicare Extra Help program in the following ways.

By Phone

Call 1-800-772-1213 between 7:00 a.m. and 7:00 p.m., Monday through Friday. TTY users call 1-800-325-0778.

Apply Online

Complete an online application. (By clicking on this link you will be leaving the Health Net Medicare Advantage for California website.)

Social Security Online Application

In Person

Stop by your local Social Security office.

By Phone

Call 1-800-772-1213 between 7:00 a.m. and 7:00 p.m., Monday through Friday. TTY users call 1-800-325-0778.

Apply Online

Complete an online application. (By clicking on this link you will be leaving the Health Net Medicare Advantage for California website.)

Social Security Online Application

In Person

Stop by your local Social Security office.

After you apply, you will get a letter letting you know if you qualify for Extra Help and what you need to do next.

Level of Extra Help (Low Income Subsidy)

Your total monthly plan premium, copays, and deductibles may vary based on the level of Extra Help you receive.

The Low Income Subsidy (LIS) table shows you what your monthly plan premium will be if you get Extra Help.

Please select the document for your plan and county. If you have questions, call Member Services. We’re here to help.

For HMO Members
Plan	CMS#	County	Low Income Subsidy
Health Net Healthy Heart (HMO)	H0562 - 009	San Francisco	Low Income Subsidy, H0562 - 009 - English (PDF) Low Income Subsidy, H0562 - 009 - Spanish (PDF) Low Income Subsidy, H0562 - 009 - Chinese (PDF)
Health Net Healthy Heart (HMO)	H0562 - 012	San Diego	Low Income Subsidy, H0562 - 012 - English (PDF) Low Income Subsidy, H0562 - 012 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 039	Yolo	Low Income Subsidy, H0562 - 039 - English (PDF) Low Income Subsidy, H0562 - 039 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 068	Alameda & Stanislaus	Low Income Subsidy, H0562 - 068 - English (PDF) Low Income Subsidy, H0562 - 068 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 079	Kern	Low Income Subsidy, H0562 - 079 - English (PDF) Low Income Subsidy, H0562 - 079 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 084	Placer, Sacramento	Low Income Subsidy, H0562 - 084 - English (PDF) Low Income Subsidy, H0562 - 084 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 090	Fresno	Low Income Subsidy, H0562 - 090 - English (PDF) Low Income Subsidy, H0562 - 090 - Spanish (PDF)
Health Net Ruby Select (HMO)	H0562 - 097	San Francisco	Low Income Subsidy, H0562 - 097 - English (PDF) Low Income Subsidy, H0562 - 097 - Spanish (PDF) Low Income Subsidy, H0562 - 097 - Chinese (PDF)
Health Net Ruby Select (HMO)	H0562 - 103	Yolo	Low Income Subsidy, H0562 - 103 - English (PDF) Low Income Subsidy, H0562 - 103 - Spanish (PDF)
Health Net Ruby Select (HMO)	H0562 - 112	Fresno	Low Income Subsidy, H0562 - 112 - English (PDF) Low Income Subsidy, H0562 - 112 - Spanish (PDF)
Health Net Ruby Select (HMO)	H0562 - 113	Alameda	Low Income Subsidy, H0562 - 113 - English (PDF) Low Income Subsidy, H0562 - 113 - Spanish (PDF) Low Income Subsidy, H0562 - 113 - Chinese (PDF)
Health Net Healthy Heart (HMO)	H0562 - 119	Imperial	Low Income Subsidy, H0562 - 119 - English (PDF) Low Income Subsidy, H0562-119 - Spanish (PDF)
Health Net Ruby (HMO)	H0562 - 120	Santa Clara and Stanislaus	Low Income Subsidy, H0562 - 120 - English (PDF) Low Income Subsidy, H0562 - 120 - Spanish (PDF)
Health Net Seniority Plus Sapphire (HMO)	H0562 - 122	Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, Santa Clara and Stanislaus	Low Income Subsidy, H0562 - 122 - English (PDF) Low Income Subsidy, H0562 - 122 - Spanish (PDF)
Health Net Healthy Heart (HMO)	H0562 - 123	Los Angeles, Orange, Riverside and San Bernadino	Low Income Subsidy, H0562 - 123 - English (PDF) Low Income Subsidy, H0562 - 123 - Spanish (PDF)
Health Net Ruby Select (HMO)	H0562 - 124	Placer and Sacramento	Low Income Subsidy, H0562 - 124 - English (PDF) Low Income Subsidy, H0562 - 124 - Spanish (PDF)
Health Net Gold Select (HMO)	H0562 - 125	Los Angeles and Orange	Low Income Subsidy, H0562 - 125 - English (PDF) Low Income Subsidy, H0562 - 125 - Spanish (PDF)
Health Net Gold Select (HMO)	H0562 - 126	Riverside and San Bernadino	Low Income Subsidy, H0562 - 126 - English (PDF) Low Income Subsidy, H0562 - 126 - Spanish (PDF)
Health Net Sapphire Premier (HMO)	H3561 - 002	Alameda, Fresno, Kern, Los Angeles, Orange, San Diego,San Francisco & Tulare	Low Income Subsidy, H3561 - 002 - English (PDF) Low Income Subsidy, H3561 - 002 - Spanish (PDF)
Health Net Sapphire Premier (HMO)	H3561 - 004	Imperial, Riverside & San Bernardino	Low Income Subsidy, H3561 - 004 - English (PDF) Low Income Subsidy, H3561 - 004 - Spanish (PDF)
Health Net Sapphire Premier II (HMO)	H3561 - 005	Alameda, Fresno, Kern, Los Angeles, Orange, San Diego, San Francisco and Tulare	Low Income Subsidy, H3561 - 005 - English (PDF) Low Income Subsidy, H3561 - 005 - Spanish (PDF)
Health Net Sapphire Premier II (HMO)	H3561 - 006	Imperial, Riverside, and San Bernardino	Low Income Subsidy, H3561 - 006 - English (PDF) Low Income Subsidy, H3561 - 006 - Spanish (PDF)

For HMO SNP Members
Plans	CMS#	County	Low Income Subsidy
Health Net Amber I (HMO D-SNP)	H0562 - 055	Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco & Tulare	Low Income Subsidy, H0562 - 055 - English (PDF) Low Income Subsidy, H0562 - 055 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 092	Kern, Los Angeles & Orange	Low Income Subsidy, H0562 - 092 - English (PDF) Low Income Subsidy, H0562 - 092 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 114	San Diego	Low Income Subsidy, H0562 - 114 - English (PDF) Low Income Subsidy, H0562 - 114 - Spanish (PDF)
Health Net Jade (HMO C-SNP)	H0562 - 118	Fresno and San Francisco	Low Income Subsidy, H0562 - 118 - English (PDF) Low Income Subsidy, H0562 - 118 - Spanish (PDF)
Health Net Seniority Plus Amber II (HMO D-SNP)	H0562 - 121	Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco and Tulane	Low Income Subsidy, H0562 - 121 - English (PDF) Low Income Subsidy, H0562 - 121 - Spanish (PDF)
Health Net Seniority Plus Amber II Premier (HMO D-SNP)	H3561 - 001	Fresno and Sacramento	Low Income Subsidy, H3561 - 001 - English (PDF) Low Income Subsidy, H3561 - 001 - Spanish (PDF)

Medicare Extra Help |

Medicare's "Extra Help" Program

For HMO Members

For HMO SNP Members

Extra Help with Medicare

What does Medicare Extra Help cover?

See if You Qualify for Extra Help

Apply for Extra Help

By Phone

Apply Online

In Person

By Phone

Apply Online

In Person

Level of Extra Help (Low Income Subsidy)

For HMO Members

For HMO SNP Members

Medicare Extra Help |

Medicare's "Extra Help" Program

Low Income Subsidy (LIS) 2020

For HMO Members

For HMO SNP Members

Extra Help with Medicare

What does Medicare Extra Help cover?

See if You Qualify for Extra Help

Apply for Extra Help

By Phone

Apply Online

In Person

By Phone

Apply Online

In Person

Level of Extra Help (Low Income Subsidy)

Low Income Subsidy (LIS) 2021

For HMO Members

For HMO SNP Members