Health Net offers several Medicare Advantage and prescription drug plans in Arizona for 2009, including HMO, PPO, and Special Needs Plans. The document provides an overview of the different plan options, including Ruby Option 1 which has no monthly premium and covers hospital stays and doctor visits with only small copays. It also describes a Medication Therapy Management program and drugs that may be covered under Medicare Part B. Contact information is provided for questions.

1. 2009
SUMMARY OF BENEFITS
Health Net Ruby Option 1
Health Net Ruby Option 2
Health Net Ruby Option 3
health net of arizona (h0351)
Health Net is a proud sponsor
of the Start! movement in Arizona.

2. 3
WHAT IS A MEDICATION THERAPY MANAGEMENT (MTM)
PROGRAM?
A Medication Therapy Management (MTM) Program is a free service we
may offer. You may be invited to participate in a program designed for
your specific health and pharmacy needs. You may decide not to
participate, but it is recommended that you take full advantage of this
covered service if you are selected. Contact Health Net for more details.
WHAT TYPES OF DRUGS MAY BE COVERED UNDER
MEDICARE PART B?
Some outpatient prescription drugs may be covered under Medicare Part
B. These may include, but are not limited to, the following types of
drugs. Contact Health Net for more details.
• Some Antigens: If they are prepared by a doctor and administered by a
properly instructed person (who could be the patient) under doctor
supervision.
• Osteoporosis Drugs: Injectable drugs for osteoporosis for certain
women with Medicare.
• Erythropoietin (Epoetin alpha or Epogen®): By injection if you have
End-Stage Renal Disease (permanent kidney failure requiring either
dialysis or transplantation) and need this drug to treat anemia.
• Hemophilia Clotting Factors: Self-administered clotting factors if you
have hemophilia.
• Injectable Drugs: Most injectable drugs administered incident to a
physician’s service.
• Immunosuppressive Drugs: Immunosuppressive drug therapy for
transplant patients if the transplant was paid for by Medicare, or paid
by a private insurance that paid as a primary payer to your Medicare
Part A coverage, in a Medicare-certified facility.
• Some Oral Cancer Drugs: If the same drug is available in injectable
form.
• Oral Anti-Nausea Drugs: If you are part of an anti-cancer
chemotherapeutic regimen.
• Inhalation and infusion drugs provided through DME.
Please call Health Net of Arizona, Inc. for more information about
Health Net Ruby Option 1, Health Net Ruby Option 2, and Health Net
Ruby Option 3.
Visit us at www.healthnet.com or call us:
Customer Service Hours: 8:00 a.m. - 8:00 p.m., 7 days a week,
Mountain Time.
Current members should call toll-free 1-800-977-7522 for questions
related to the Medicare Advantage Program or for questions related to the
Medicare Part D Prescription Drug program.
(TTY/TDD 1-800-977-6757)
Prospective members should call toll-free 1-800-422-7311 for questions
related to the Medicare Advantage Program.
(TTY/TDD 1-800-977-6757)
Prospective members should call locally 1-800-422-7311 for questions
related to the Medicare Advantage Program.
(TTY/TDD 1-800-977-6757)
Prospective members should call toll-free 1-800-422-7311 for questions
related to the Medicare Part D Prescription Drug program.
(TTY/TDD 1-800-977-6757)
Prospective members should call locally 1-800-422-7311 for questions
related to the Medicare Part D Prescription Drug program.
(TTY/TDD 1-800-977-6757)
For more information about Medicare, please call Medicare at
1-800-MEDICARE (1-800-633-4227). TTY users should call
1-877-486-2048. You can call 24 hours a day, 7 days a week.
Or, visit www.medicare.gov on the web.
If you have special needs, this document may be available in other
formats.

3. benefithighlights
arizona
2009

4. HEALTH NET
MEDICARE PLANS
AT A GLANCE
Which plan option is right for you?
Health Net Medicare Advantage and Prescription Drug Plans offer freedom, flexibility, and a
choice of little or no monthly plan premiums to fit your needs and protect yourself or a loved
one from unexpected medical expenses. We offer the convenience of virtually no paperwork
and excellent customer support. With our HMO plans, you can choose from a network of
highly qualified providers in your area. With our PPO plan, you have the freedom to see doctors
who are in our network, or pay a little more to seek care from out-of-network Medicare-
participating providers. Or with our Prescription Drug Plans, you will have a broad choice
of generic and brand-name drugs Medicare beneficiaries are most likely to use, with affordable
copayments.
Not everyone is looking for the same coverage. That’s why Health Net tailors its plans to meet
individual needs. See the following pages in this brochure to help determine which plan might
be right for you.
We are here to help.
For more information about our plans or to enroll, please contact us at: 1-800-333-3930
(TTY 1-800-977-6757 for the hearing impaired), 8:00 a.m. - 8:00 p.m., 7 days a week.
Or visit our web site at www.abetterdecision.com.

5. ruby
“I’m looking for a medical plan that includes prescription drug coverage and is more
affordable than most Medicare Supplement plans.” Ruby provides cost effective medical and
prescription drug coverage in one simple plan. Our Ruby plans offer a range of premium and
copayment options depending on your needs. Whether you see your primary care physician or
specialist often, or are enjoying good health and rarely need hospital care, there is a Ruby option
for you.
amber
“My Medicare and Medicaid give me basic benefits, but I need more coverage.” Amber is
Health Net’s Special Needs Plan for Medicare/Medicaid Dual Eligibles and includes Part D
Prescription Drug coverage. Amber is available to those who have qualified financial status as
determined by government guidelines and provides medical and drug coverage at costs that may be
greatly reduced or even eliminated.
sage
“I have a history of high cholesterol (greater than 200mL) and am looking for a plan that
can manage my health needs.” Health Net Sage is our chronic condition Special Needs Plan that
comes with $0 copayments for Healthy Heart preferred generic statin drugs, so Sage members have
easier access to cholesterol-lowering medications. Sage includes education to help members
understand how to lower risks related to high cholesterol, and provides health coaches and regular
communications about achieving a healthy lifestyle.
Violet
“I want medical and prescription drug coverage like the Ruby plan, but with the flexibility
to use doctors outside of the Health Net network.” Violet is our Preferred Provider Organization
(PPO) plan that not only offers medical and drug coverage with affordable copayments for in-
network services, but also gives you the freedom to see out-of-network physicians who accept
Medicare. This is beneficial if you want to see providers who are not contracted with Health Net, or
spend time in another state. Should you choose to use an out-of-network provider, you may pay a
little more than if you use in-network providers.
green
“I’m only looking for complete medical coverage at an affordable price.” Health Net Green is
your ideal medical-only plan that does not include drug coverage. This is a cost-conscious plan for
those with prescription drug benefits through another plan or if you have chosen not to have drug
coverage.
orange
“I already have medical coverage through a previous employer, another agency, or Original
Medicare, and am only looking for drug coverage.” Orange is Health Net’s Medicare Part D
Prescription Drug Plan (PDP) that features many commonly prescribed generic and brand-name
drugs from an extensive drug list. Prescription medications can easily be filled at any of Health Net’s
participating network pharmacies nationwide, including a reliable mail order option.

6. Ruby option 1
b e n e f i t s o v e r v i e w
medical benefits with prescription drug coverage (ma-pd)
monthly plan premium $0
inpatient hospital $175/day, days 1-5;
$0/day, days 6 and beyond
skilled nursing care
(covered for 100 days per benefit period)1
$0/day, days 1-20;
$100/day, days 21-100
primary care physician (pcp) office
visit (includes routine annual physical)
$5 per visit
specialist office visit $40 per visit
outpatient hospital (per visit) $0 non-surgical; $200 surgery
ambulance $200 per one-way trip
emergency care (worldwide coverage) $50 per visit
urgent care $40 per visit
Preventive Care
(office visit copayment may apply)
$0 per visit
Clinical/Diagnostic Lab
(blood draw, PSA test)
$0 per visit
Physical/Occupational/
Speech Therapy Cardiac Rehab
$40 per visit
Diabetic supplies $0 per item
x-rays/radiology (per visit) $25 X-ray; $125 CT; $150 MRA/MRI;
$200 PET Nuclear Medicine
health club membership
(at contracted facilities)
No charge
optional benefit package
monthly plan premium $29
gold benefits Alternative Medicine, Dental and Vision

7. THE
SIMPLE
TRUTH
Why is choosing a health care company so
complicated?
The simple truth is, it doesn’t have to be.
Health Net knows how challenging
Medicare can be, especially with the
introduction of the Part D Prescription
Drug Benefit.
Medicare
Plans
Medicare Made Simple
it’s
EASY
TO APPLY
You can schedule an in-home appointment
or you can attend one of our informational
seminars.
Call a Health Net
Sales Representative
or contact your
personal broker
for more details.
Health Net of Arizona, Inc. is a
Medicare Advantage Organization with
an annually renewed Medicare contract.
Anyone entitled to Medicare Part A and
enrolled in Part B may apply. Members
must continue to pay Medicare
premiums. Health Net Medicare
Advantage HMO plan members must
use contracting providers for routine
care. Limitations, copayments and
coinsurances will apply. Health plan
premiums and benefits vary by plan.
Health Net®
is a registered service mark
of Health Net, Inc. All rights reserved.
6012004 AZ32826 (9/06)
H0351_2006_181 CMS approval: 11/1/06

8. attention, you’ll know what you’re covered
for – and you’ll be covered from your very first
physician visit.
We strive for the highest quality care possible.
That’s why our vast network of contracted
physicians, hospitals, pharmacies and medical
professionals has been built with such
precision and care – to give you access to the
best care we possibly can.
We tailor our services to Medicare
beneficiaries like you. We know which
conditions are most likely to affect you and
the medications you’re most likely to need.
That’s why we’ve taken such care to ensure
that our plans offer coverage for so many
commonly prescribed brand name drugs.
Even if your physician changes your
medications, your new prescription will most
likely still be on our list of covered drugs.
We give you Decision Power.SM
Health Net
provides many of its medical plan members
with a remarkably innovative program called
Decision Power.SM
This exclusive program
provides you access to Health Coaches 24
hours a day, 7 days a week, at no extra charge.
These trained professionals will answer your
health questions, and even help you create a
set of personalized health goals. It’s an
empowering program and it works!
WHY NEARLY
A HALF MILLION
PEOPLE HAVE
ALREADY
CHOSEN
HEALTH NET
MEDICARE PLANS
We make understanding our plans easy.
Our plans are named after colors – we’ve
eliminated the language that makes plans so
hard to understand. Plus, we give you side-
by-side comparisons of our plans so you can
easily determine which one is right for you.
We show you what your costs may be before
you sign up. We’ve even gone so far as to
eliminate deductible payments and other
costs for most common services in our
medical plans. Before you seek medical
HOW TO CHOOSE
THE PLAN THAT’S
RIGHT FOR YOU
Not everyone is looking for the same coverage.
That’s why Health Net tailors its plans to
individual needs. To help determine the plan
that might be right for you, call one of our
friendly Health Net Sales Representatives, or
contact your personal broker.
Health Net Ruby is just one of the many plans
offered by Health Net. Ruby is our HMO, or
Health Maintenance Organization, medical
plan that comes with our cost-effective
Prescription Drug Plan. This gives you the
convenience of having all your needs – medical
and drug – coordinated by one company.
Call today:
1-800-892-2041
For the hearing impaired:
TTY 1-800-977-6757
8:00 a.m. to 8:00 p.m., 7 days a week
Health Net Ruby
Benefit
You
Pay
Monthly Plan Premium $0
Primary Care Physician
Office Visit
$0
Specialist Office Visit $35
Inpatient Hospital
(per admission)
$200
Outpatient Surgery (per visit) $150
Emergency Care
(worldwide coverage)
$50
Prescription Drugs1
- Annual Deductible
- Preferred Generic Drugs
- Preferred Brand Drugs
- Non-Preferred Drugs
- Initial Coverage Limit (ICL)2
$0
$0
$39
$78
$2,250
Health Club Membership
(at contracted facilities)
$0
Optional Benefits
- Alternative medicine,
vision, and dental care
$29 per
month
1
Copayments based on 30-day supply for drugs on
the Health Net Medicare Formulary. Health Net
uses a formulary, which is subject to change.
2
Initial Coverage Limit (ICL) is calculated by
adding payments made by Health Net and by you.
Once the ICL is reached, you are responsible for
100% of your Part D drug costs until your total
out-of-pocket Part D drug costs reach $3,850.