Health Plan of Nevada HMO
Health Plan of Nevada HMO
Health Plan of Nevada (HPN) HMO is offered to members who work or reside in Clark County, Esmeralda County, and Nye County. This plan offers affordable copays and your benefits are easy to understand and access.
For maximum coverage and the lowest out-of-pocket expenses, please be sure to choose your primary care provider (PCP) when you enroll in in HPN. As your partner in health, your PCP will help coordinate all of the health care services you need.
- Every member of your family may choose a different PCP
- You may select a pediatrician as your child’s PCP
- All female members ages 14 and older may choose an OB/GYN in addition to a PCP
Note: You may change your PCP at any time. Changes become effective on the first day of the following month. For example, a change made on January 16 becomes effective on February 1. To change your PCP, call HPN Member Services at 702-242-7300 or 1-877-545-7378.
The HPN provider directory contains information to help narrow your choices. You’ll find the specialty, office address, telephone number, and board certification status of every contracted provider in the HPN network. You can view the provider directory here.
- Open access (referrals not required to see an in-network specialist)
- Low, fixed out-of-pocket costs
- No annual deductibles
- No coinsurance
- No claim forms
- No pre-existing condition exclusions or limitations
- Primary care physician required (will coordinate and monitor your care)
- Timely access to care requirements.
- 100% preventive care benefit
- Urgent care and emergency care services covered nationwide and worldwide
- Large pharmacy network including mail-order prescription program
- Online web portal
- Online appointment scheduling and express check-in at Southwest Medical Associates
- Online access to medical and prescription records
- Health education programs
Eligible dependents enrolled in an accredited college, university or vocational school anywhere in the United States will now be able to access a plan contracted network provider for needed PCP or urgent/emergent services at the in-network level of benefits. With the exception of Urgent or Emergent Services, Prior Authorization will still be required for all covered services outside of the HPN Service Area to receive in plan benefits. While attending school in Northern Nevada, students are able to directly access the Northern Nevada HPN HMO Network of physicians.
Participants and their dependents will now be able to access a plan contracted network provider for certain covered services while traveling in the United States, and unanticipated healthcare issues occur. Other than Urgent or Emergent services, Prior Authorization will be required or the member may be subject to non-plan benefits. While traveling from Southern Nevada to Northern Nevada, HPN Members are allowed to directly access the Northern Nevada HPN HMO Network of physicians.
For detailed information regarding HPN’s plan design, view HPN’s Evidence of Coverage Certificate here
