Residents of California need not worry about shopping for health insurance plans with the state marketplace to help them. Covered California provides various health plans to eligible members based on their preferred coverages, with essential benefits like emergency care, hospitalization and primary doctor care.
Open enrollment, the application period for acquiring health care under the Affordable Care Act (ACA), has already ended last February 2015. Individuals and families may still apply for coverage under a Special Enrollment period, however, given life-changing events like childbirth or marriage, and other qualifying factors.
The problem left now is choosing the right kind of health insurance that will work for you. To ensure a constructive health plan investment, there are three basic factors that you have to consider when comparing insurance options with a covered California agent.
Under the ACA, all health insurance plans must include 10 “essential health benefits”, including hospitalization, emergency services, rehabilitation services, and others. If you are employed, you may simply ask your employer for the Summary of Benefits and Coverage, a standard document detailing all the assistance included in the company’s medical plan.
Plans that were purchased and started before the implementation of the ACA may not include a few of these coverages. The law still allows renewal of these older plans, but you have the option to purchase a new comprehensive plan instead. Consult an experienced Covered California agent to find out more about your insurance options.
Coverage of monthly premiums are identified through what is known as “metal tiers”, specifically bronze, silver, gold and platinum.
- Bronze plans require the least premium payments but also involve higher out-of-pocket expenses.
- Platinum offers the most coverage and lowest out-of-pocket contributions, but also require the highest premiums.
- Out-of-pocket expenses are what you pay on your own for the healthcare you receive, including copays, deductibles, and coinsurance.
Doctors and Hospitals
Health insurers have their own network of medical professionals, institutions and pharmacies, which deliver the needed services. If you want to continue seeing certain physicians, check to make sure they are part of a potential provider’s network.
The many different options you have makes working with an accredited Covered California agent very helpful. Companies like Good and Associates Insurance Services offer web-based information and a user-friendly search system, which enable customers to review the products and services of small-scale and major insurance companies. You may also request a home appointment with representatives of these firms for your convenience.
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