Archive for the ‘California Health Insurance’ category

California’s Brand New Health Insurance Exchange: Your Questions Answered

October 11th, 2013

In honor of the fact that open enrollment for California’s health insurance exchanges went live on October 1st – leaving California citizens, of course, with many questions – it’s decidedly worth reviewing what this means for the state.

Covered California is a new by the state, for the state agency that was put in place in order to supervise the buying and selling of health insurance and to help enroll eligible candidates for coverage.

Who does it benefit?

There are three main demographic groups who will benefit from the new healthcare exchanges: the poor, the low-income working class, and anyone who buys their own insurance. Essentially, anyone with an income below $15,400 per year will be qualified to take advantage of Medicaid – or Medi-Cal, as it is known in California. It is projected that this will help some 2.3 million uninsured Californians enroll in an individual California health insurance plan within the next 3 years.

What about immigrants?

Under this new plan, legal immigrants are eligible to purchase insurance plans through Covered California. They are also available for the government subsidies if they are qualified in terms of their income. However, illegal immigrants cannot buy insurance and are not eligible for Medicaid.

What will it offer?

Essential benefits are required under the new act, which include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitation services and equipment, laboratory services, chronic disease management services, preventative and wellness services, and pediatric services.

What are the bronze, silver, gold, and platinum color codes?

There are three different types of coverage policies available, and they are color-coded to match their offerings. The color codes reflect what percentage of health care costs will be covered by the insurance plan, as well as how much the monthly premiums and copays will cost for doctor visits and prescription drugs. Bronze is the lowest-cost plan, and on this plan the insurance company will cover 60% of expenses, leaving 40% to be billed to the patient. A Silver coverage plan will offer an average of 70% of expenses paid by the insurance company, and Gold will have an average of 80% paid by the insurance company. Platinum, on the other hand, offers the most coverage – up to 90% to be paid by the insurance company – but is also the most expensive on a month-to-month basis. According to Forbes, “Your share of costs might come in the form of a large deductible with low coinsurance once you’ve met your deductible. Another plan might offer a low deductible with higher coinsurance.”

As the result of these changes, it’s estimated that 2.6 million people will now be qualified to take advantage of financial assistance in paying for health insurance. Another 2.7 million will be newly eligible for guaranteed coverage. Emergency services will no longer be denied to those who can’t outright afford it in the state of California.

Young Professionals: “My Employer Doesn’t Offer Healthcare”

June 19th, 2013

In the United States, healthcare is a topic that is consistently on the tongues of legislators, and yet somehow, it’s still not discussed enough – especially when it comes to young adults (aged 18-24). In fact, young adults make up the segment of the American population that is most likely to be uninsured due to losing coverage once they’re off their parents’ plans. According to the 2007 bureau, nearly 8 million young adults went without health insurance – that’s 28% of that age group’s population.

So what exactly are a young adult’s options for health insurance? Not every workplace offers it to new employees, but that doesn’t leave you high and dry. You do have options, in part due to the implementation of the Affordable Care Act.

Did You Know: The Age of Dependency has been Extended

Many young adults aren’t aware that they can still be insured as a dependent on their parents’ healthcare plans after they turn eighteen. Due to the Affordable Care Act, you can still be listed as a dependent until you’re 26 years old if you don’t get job-based coverage. This buys you a little extra time to get settled into a career and get job-based coverage or find an independent plan.

For Young Adults with Limited Income

If you don’t have health insurance because you can’t afford it, 2014 may be your year. Starting next year, unemployed adults with limited income may be eligible for free health insurance through Medicaid.

Buying Insurance Independently

It may become your only option if your parents don’t have health insurance and you’re self-employed, unemployed, or new to the workforce. Buying health insurance, if you can afford it, is sometimes a necessity – though it might be a bit expensive, an uninsured trip to the hospital is even more expensive. It’s all about shopping smart. Remember that a lower premium, though it may appear to be more desirable, usually offers less comprehensive coverage or a very steep copay. Try using sites that offer health insurance quotes, like this one for Anthem Blue Cross of California, while also having thorough information about the coverage, and choose the best option.

What Else you should Know…

Remember that if you buy a short-term plan just to last you until you get a better one, it will likely be expensive and have limited coverage, so only do so if necessary. If you’re newly married, don’t forget about maternity coverage – this is something newlyweds often forget! And finally, there are many new changes coming in 2014 that will benefit the unemployed and low-income workers.

California Health Insurance

June 6th, 2013

Getting a quote has never been easier in today’s marketplace.  By visiting, you can quickly get health insurance quotes from all the major carriers in California.  Additionally, you can filter by how much you want to spend, what type of plan and coverage you want, and also by which carrier you prefer.  Individual California health insurance can be a little complex if you do not have the right tools in place.  With our quick and easy process, you can obtain all the information you need to make a correct choice about health insurance.  If you are having trouble deciding which plan is best for you, call our experts and they will assist in making you sure you pick the right coverage for you and your family.

Finding The Right Plan

May 16th, 2013

In California, there are many options when it comes to health insurance.  Many carriers are trying to sell you their insurance plans based on the strength of their network, coverage and affordable prices.  However, recently, it has been more and more difficult for consumers to find affordable health insurance plans.  This does not just apply to California health insurance plans, many people across the country are dealing with high price insurance options.  This is part of the main reason Obama passed the health care reform laws over three years ago.  His ultimate goal is to make health insurance more affordable for all Americans.

In 2014, no one can be denied health insurance, regardless of your pre-existing condition.  So this is a really good thing.  However, no one really knows the true impact that will have to prices.  Keeping the cost constant for a bit, then it will come down to coverage and carrier.  When shopping for individual health insurance in the near future, it will be important to understand everything you are getting when making a decision.  Research if your doctors are covered with the carrier.  Know what is the difference between out-of-pocket maximums and deductibles.  Figure out which coinsurance limit will be best suited for you and your health history.  We will find out real soon how the health insurance industry will evolve because of the health care reform.

Health Care Reform Needs The Right Leaders

January 21st, 2013

As the exchange era approaches and the reform bills take affect, many are still wondering what the overall result will be.  As of late, many have seen there health insurance premiums double with no explanation.  Also, many are still without health insurance because it is still way too expensive.  It is estimated that there are still over 40 million Americans without health insurance today.  That number is obviously why President Obama is trying to overhaul the system with his laws that were passed over two years ago.  In California, there are currently over 8 million uninsured, one of the highest figures in the country.  So, how will the exchanges get these millions of Americans insurance?  How long will it take for everyone to get health insurance?  5 Years?  20 years?  Another question, will people simply pay the fees associated with not having insurance because that it is still much cheaper than actual health insurance premiums.

Many people who make $10 dollars an hour, trying to make a living, do not have and can’t afford to get health insurance.  America needs quality leaders to oversee the health care system and the implementation of it coming next year.  Most are predicting that the healthy will pay for the poor, just like the rich pay for the poor when it comes to government programs, etc.  Next year everything takes affect, we will find out soon.

Higher Health Insurance Premiums On The Way

January 7th, 2013

Obamacare has been at the forefront the last three years and has been one of the most important issues the Obama administration has handled in their term.  As Obama’s four year term is coming to an end and the new term is starting, many consumers are wondering why insurance premiums are continuing to rise.  Also, many are now questioning how it will all of sudden start to decrease starting in 2014.  Aetna, one of the largest insurers in the United States, says health insurance premiums may go up as much as 20 to 50 percent in 2014.  Blue Shield mentioned that some markets may even double by the time the health care reform really starts in 2014.  So why is this really happening?  Many critics of the health care reform saw this coming from a mile away.  This is because, starting in 2014, no one can be denied health insurance coverage.  Anyone can apply through the health insurance exchanges, or direct, and get approved for health insurance even if they have a pre-existing condition.

From a care standpoint, this is obviously a great thing because everyone should have access to care.  However, from a pocket book standpoint, everyone will pay the price.  The main reason for this is because the healthy will have to pay for the sick.  There are 8 million uninsured in California alone that might be entering the market starting in 2014 when its required to have health insurance.  The sick pool will need the most money to pay for their claims, and that will only come from the healthy.

The health care laws also state that the premiums can not vary too much based on age and that it will be a community rating.  This will probably benefit the older more than it will the younger.  Since the older population have higher health costs, the younger segment will pay for this difference.  So what do we do at this point?  Well, there actually is no easy answer to that.  We have to all hope that the reform rules and regulations will not effect the market as much as all these top insurance carriers do.

What Is The Difference Between Anthem Blue Cross And Blue Shield?

October 1st, 2012

In California, Anthem Blue Cross and Blue Shield are actually different companies and are competitors.  In most other states, they are the same company and formed an association, the Blue Cross Blue Shield Association.  Anthem Blue Cross is a for profit company in California, and Blue Shield is a non-profit.  Both insurance companies have large networks and very good doctors.

Anthem Blue Cross does more volume in California than Blue Shield does and they have more members.  Also, the network of hospitals and doctors is the largest under Anthem Blue Cross.  Ous website, sells more Anthem Blue Cross plans than any other carrier.  That being said, many other carriers have strong plans and networks – Blue Shield, Aetna, Cigna, Healthnet, and Kaiser.  Depending on what types of benefits you want and how much you want to spend, picking a carrier will become easier once you narrow down the options.

Receiving Medical Care Without The Stress

September 13th, 2012

Many people today worry that they might not have the right insurance plan in place.  There are many moving parts and many things to know when you buy health insurance.  For instance, you must know the difference between things like deductible, out of pocket maximums, carriers, etc.  Many questions we get are about these benefits and what really is the difference.  Well, the answer is straight forward but not very easy to decide on.  Usually, the higher the deductible you choose, the less expensive the insurance plan will be.  That being said, the benefits are not as rich and it might cost you in your pocket book if you start to utilize medical services a lot.

Healthier people choose higher deductible plans because they obviously use the doctors less, so they will and can take the risk.  If you are approaching higher age brackets, it might make sense to choose a plan with a lower deductible.  Yes, this plan may be more expensive than the average plan, but you will save money in the long run if you start to use medical services.  The main thing is to know your health history and choose accordingly.  That way, when you do receive care you know that you have the right coverage in place.

Adding Maternity Coverage To Your Plan

September 5th, 2012

In California, all individual and family health insurance plans added maternity coverage starting in July.  That is great news for a lot of people.  This is because, before, many plans did not offer coverage and the ones that did were very expensive.  Additionally, many individuals would wait until they were expecting a child and then apply for coverage.  Health insurance carriers viewed this as a pre-existing condition and many would deny coverage to the applicant.

Now, because of the health care reform, maternity coverage is included on the health insurance plans.  And the coverage is good because it covers the doctor visits, ultra-scans, and hospital stays.  An interesting fact about hospitals stays though, is that some hospital charges will actually be accessed on the child.  So its important that you add the new born quickly to the plan.  In California, most carriers give you 10-30 days to add the child to the health insurance plan.

What Is Not Covered Under Health Insurance

August 15th, 2012

Individual health insurance plans are different than health insurance plans you might of had while working for a company.  Individual plans do not include all types of coverages so it is important to read the benefit details before choosing a plan.

For instance, many people do not know that maternity if not covered under most individual health insurance plans.  This is very important to know.  In fact, it is very difficult to add health insurance coverage after you find out your pregnant.  Many people want to try to get health insurance once they realize of the cost associated with the pregnancy.  Health insurance carriers
are well aware of these high costs and will usually decline coverage if you apply after the fact.

Other types of services usually not covered by health insurance are physical therapy, fertility treatment, cosmetic or elective surgery, weight control services and many other things.  It is extremely important to know what types of services you need based on your current health.  And also, to read the benefit details before making a final decision on the health insurance plan.

Why Does Insurance Keep Rising?

August 7th, 2012

Each year, consumers see their health insurance premiums increase and there are no signs of it getting better anytime soon.  Why do these premiums keep going up and not down?  Why hasn’t the government stepped in and tried to help?  Well the quick answer is that the government passed the health care reform with the exact attempt to make health insurance more affordable for everyone.  The reason premiums increase each year, and why the health reform was passed, is obviously very complex and confusing.  Starting with the health care system, all the way from hospitals to doctors, is very broken and tiered.  Meaning, there are many doctors that are incentivized by different things.

Some want to see as many patients as possible, which obviously lowers quality of care.  And some doctors, only deal with certain markets, providers, carriers, etc. and that leads to other hosts of issues.  The only way that health insurance will become affordable is if people do not game the system.  The major reason health reform might not succeed is that adverse selection might become a big issue.  Since pre-existing conditions will not be an issue starting in 2014 to get approved for health insurance, many fear that the sick will only get health insurance right before a major surgery and then cancel the plan.  This means that the healthy will end up paying for the sick.  This will not make health insurance more affordable.  In fact, it will probably make health insurance more expensive in the years to come.

California Health Insurance Exchange

July 31st, 2012

In California, over 7 million people do not currently have health insurance.  And over 40 million people do not have health insurance in America.  You can see how large California is though as far as percentage of the total uninsured.  The decision last month to not overturn the health care reform, and more significantly the individual mandate, will have large affects for years to come.  So what does this really mean?  Starting in 2014, everyone in America will be forced to have health insurance and they will face a fine.  There are certain waivers, such as being on a governmental program or getting an income waiver.  But for the most part, many will be seeking health insurance in the coming months.

In California, many might seek health insurance through the exchange which has to be up and running by 2014.  There are some critics though that say the management of the exchange will be challenging.  For one, many have questions when buying health insurance and there might not be enough coverage to answer all the questions.  Buying health insurance is more complex than say, getting a plane ticket.  Also, when small businesses want to purchase health insurance through the exchange, who will be there to guide them.  Many of these questions will be answered soon in the coming months.

Adding Coverage For A Dependent

July 27th, 2012

If you are currently on a health insurance plan, there are options to expand your coverage for your family.  Many plans have great health insurance coverage for families.  For instance, if you want to add your new born child to your insurance, most carriers give you about 30 days to do so.  However, one important thing to note, it is usually more expensive to add a dependent then to insure yourself.

Family plans come in both PPO and HMO formats.  In the individual health insurance market, PPO plans are more popular and usually less expensive.  This gives the flexibility to the consumer to visit any doctor they choose and most likely have coverage for it.  One draw back of PPOs is that the benefits are usually less rich than HMOs.

Record Year For Whooping Cough

July 10th, 2012

The United States is on a record year, but not for the right reasons.  They are on pace for the most whooping cough cases than any other year.  Whooping cough, also known as pertussis, is a bacterial infection that causes a real deep cough in children.  It can be very serious if not treated right away.  It is called whooping cough because that is the noise children make after they finally catch there breath from so many coughs in a row.

This year so far, there has been over 16,000 cases of whooping cough.  Just to put it into perspective, the entire last year reported just over 15,000.  The highest ever reported and validated was in 2010 when over 27,000 cases were known.  This year, we are on pace for over 30,000 cases of whooping cough.  The best treatment is preventative.  Make sure all children get the proper shots when they are young so they can avoid this dangerous sickness.

Finding The Right Benefits For Your Family

July 6th, 2012

Recently, health insurance carriers were required to add maternity coverage for their plans in California.  Starting July 1st, all health insurance plans will include maternity and many consumers are already starting to take advantage.  If you already have an individual health insurance policy, many plans will convert with maternity coverage at your plans’ renewal.  Another important factor when thinking about getting family health insurance is the current health of your family members.  Many plans have different types of coverages and also different benefit amounts for types of services.

For instance, medication coverage differs greatly from plan to plan.  Anthem Blue Cross has health insurance plans that have strong prescription coverage and also plans that have limited coverage.  And by limited, we mean plans that have high brand deductibles which make it expensive to purchase brand medication.  To really understand which plans make the most sense for your family, research the plan details under each search result for a full break down of what the plans really offer.

What The Supreme Court Decision Means To You

July 5th, 2012

Last week, the Supreme Court ruled not to throw out the health care reform which was passed over two years ago.  Two major issues were being watched by many people.  The first one, was the Medicaid expansion and the qualifications to get insurance through Medicaid.  And the second, was whether or not the individual mandate was constitutional.  The Supreme Court ruled that the mandate is constitutional and that they will enforce the mandate as a tax.  The original pitch and what was Obama’s selling point, was that the mandate would be penalized as a fee not a tax.  So this decision is huge and can have some falling out by supporters of Obama.  Anyone who does not health insurance by 2014, will pay $95 or 1% of their income, which ever is greater.  The figures go up if you have a family that is not covered.  Also, if you still do not have health insurance by 2016, the tax will go up to 2.5%.

So the question here is, will people that are healthy still go without health insurance and pay the tax.  Or, is the tax enough to make them change their behaviors.  Most likely, the former because it still is a lot cheaper to pay the tax then pay the monthly premium on a health insurance policy.  Another issue will be how each state will proceed with implementing the health insurance exchanges by 2014.  Still, there are 26 states that are opposed to the ruling and it will be a challenge for the federal government to manage the exchanges without support on the state level.

Supreme Court Ruling

June 26th, 2012

The Supreme Court is expected to rule on the health reform laws this week.  Meaning, that this is a very important week for both the government and the American people.  There are basically three scenarios – the whole law is thrown out, only part of the law is thrown out or everything is upheld.  Most likely, many think that only part of the law will be thrown out, the individual mandate.  This has been the most controversial part of the health reform laws that says everyone must have health insurance by 2014 or face a fine.

Many Americans believe that the government overreached their boundaries by trying to impose this regulation.  The main issue is that many can not afford health insurance.  And, many feel that they are healthy and do not need to have health insurance.  The ruling will have resistance either way it is ruled.  If the law is thrown out, then the Democrats will push to repeal the decision, and vice versa.  As we wait to see what there decision will be, the election also waits in the balance and the ruling may have significant future implications.

Consumer Driven Health Insurance Plans

June 22nd, 2012

Below are some key health insurance plans that drive results.  Many take advantage of these plans but its first important to understand what they do and how it affects your health care.

High-Deductible Health Plan – As an alternative to traditional self-funded and managed care plans, more companies are considering implementing a high deductible health plan, known as an HDHP, alongside an HSA or HRA. Its purpose is to lower health care premiums by pushing plan members to analyse their health care decisions. An HSA or HRA would be used with the HDHP to help pay for the deductible costs.

Health Reimbursement Arrangement – A HRA is when an employer agrees to provide reimbursement for certain employee medical expenses. This process has always enjoyed a tax favored status as employer payments for reimbursement of IRS qualified medical expenses are deductible to the employer and not considered taxable income to the employee.

Health Savings Account – A Health Savings Account (HSA) is one of the newest and best ways for many to set aside money for inevitable health care expenses. There are many benefits for the employers and the employees when they use HSAs. They create tax-free money for un-reimbursed medical expenses and also earn tax-deferred growth. HSAs are also excellent ways to create supplemental retirement income.

Difference Between A PPO And HMO Plan

June 19th, 2012

HMO stands for Health Maintenance Organization.  These types of plans are one of the most affordable in the marketplace.  This is primarily because of the managed network structure that is in place.  Individuals who have this type of coverage have to designate a primary care physician, which will be the starting point for all medical services that might be needed through out the year.  HMO plans are  starting to become more expensive than PPO plans in the private insurance  market.  If having the flexibility of choosing your own doctor for all types of  medical services is preferred, than maybe a PPO plan is a better option for you.

PPO stands for Preferred Provider Organization.  This is also another affordable individual health insurance plan that gives people access to all health care providers within the network.  Additionally, you can also go out of network and most plans will cover you for care as well.  This type of health insurance is flexible and affordable.  Additionally, PPO plans are becoming the cheaper alternative to HMO plans.  All the major carriers such as Anthem Blue Cross of California, Blue Shield of California, Aetna and Kaiser have many PPO plans to choose from.

How Office Visit Costs Can Alter Your Health Decisions

June 14th, 2012

Some plans in the marketplace do not offer the best health coverage when it comes to visiting the doctor.  In fact, many health insurance plans have limitations when you visit your doctor.  For instance, some health insurance plans give you a limit, for instance 3 visits per year.  Then after those three visits, you will pay usually 100 percent of the negotiated rate.  That is when it can become quite expensive to visit the doctor.  The health carriers primarily did this because many individuals were over utilizing their health insurance, and eventually that would drive up the cost of health insurance.

Another option that carriers offer is a percentage rate for office visits.  This can also be very expensive.  For instance, some plans have a 50 percent charge every time you visit the doctor.  Depending on how much your particular doctor charges, it can become very costly.  It is important to point out thought that these health insurance plans mentioned usually have lower health insurance premiums per month.  So it is a trade-off.  How much do you want to pay to have the coverage versus how much you want to pay when you actually want to use the coverage.

Getting The Most Out Of Your Insurance

June 11th, 2012

Many Americans currently do not have health insurance.  The main reason, of course, is because that it is very expensive to afford the monthly premium.  Additionally, each year these premiums tend to rise making it even more difficult to hold onto.  However, there are some ways to help fight this problem.  For one, know what type of insurance you need.  If are already a healthy person but want the insurance to prevent large financial loss, then a higher deductible plan would be best for you.  If you take on more of the risk as far as the deductible, the monthly premium will be lower and more affordable for you.  Also, if you are not particular about which doctor you want, then choosing a carrier with a smaller network will also lower your premium.

The health reform will also bring more changes as the law progresses.  Meaning, if the health insurance exchanges happen in 2014, that should also make health insurance more affordable for the consumer.  Another idea to lower your insurance premium is to choose plans with medication benefits only if you need them.  Prescription coverage is very expensive for a carrier, so only choose plans with that coverage if you truly need it.

Individual Plans Offer Maternity Coverage

June 8th, 2012

Before July of this year, many individual health insurance plans did not offer maternity coverage.  And if you picked a particular plan that had some type of maternity coverage, the coverage was limited and the plan was very expensive.  Now, the marketplace has changed a little bit.  Whether a direct result of the health reform or not, all carriers are offering plans that cover maternity and it is not at a hefty price.

Many individual health insurance plans have actually become more affordable while offering better benefits.  This is usually not the case in the individual health insurance market.  Usually when carriers offer better benefits for their health insurance plans, they usually charge you more per month.  Many are taking advantage of these great benefits, especially since there is uncertainty because the Supreme Court is scheduled to rule on the health reform any day now.

Supreme Court Decision Drawing Near

June 4th, 2012

The health reform was passed well over two years ago and has not gone without debate.  Many parts of the reform have already been implemented and have had a positive impact.  For instance, the lifetime maximum was lifted so no one can be limited by the amount of medical services they can receive.  This is very important for those patients who are terminally ill and rely of medical services to keep them alive.  Also, the age was increased for dependents to be on their parents’ health insurance to age 26.  As the economy continues to struggle, many are relying on others to pay their health insurance premiums.

However, the most important part of the reform is still being debated, and that is whether or not the individual mandate is constitutional.  Starting in 2014, the reform says that everyone must have health insurance and they will face a penalty from the government.  The Supreme Court is ruling on this and the results will have a huge impact on health care and the economy as a whole.

Getting The Most From Your Drug Benefits

May 18th, 2012

What can of medications do you take every year?  Do you have a monthly or weekly need when it comes to prescription drugs?  Do you take more generic or brand medications?  These questions are very important to think about before you start researching individual health insurance plans.  Many plans offer prescription coverage, but some do not.  Also, it is important to research the plan details and especially the limitations, if any, on the drug coverage.

Carriers, to keep the monthly premium low, will offer plans with weaker drug benefits.  For instance, some individual health insurance plans will have large brand deductibles on their medication coverage.  Some are even as high as $7,500 for their brand deductible.  So this is essentially saying that you will have to pay for most of your brand drugs yourself.  Other plans have lower brand deductibles but will cost you more per month.

Getting The Right Drug Benefits

May 11th, 2012

Many health insurance plans have drug benefits.  It is important to research all the benefit details so you know what type of coverage each plan offers.  Most individual health insurance plans come in the PPO form, and most come with some type of prescription coverage.  However, not all of them cover the full range of drug types.  For instance, generic drugs for the most parts are always covered if plans cover prescription medications.  Brand and tier 3 drugs are sometimes not covered.  Also, the level of coverage is not always the same.

For brand medication, which is the most common type of medications purchased, usually have a deductible portion on the insurance plan.  Meaning, you have to first meet the brand deductible before you can start paying the co-pay amounts.  And these deductibles vary greatly.  If you take a lot of medication on a frequent basis, consider choosing a health insurance plan with a low brand deductible.  Or, see if the drugs you take come in generic form.