Affordable California Individual Health Insurance

Individual Health Insurance in California

Purchasing individual health insurance in California can be very confusing. With so many plans on the market, it’s hard to determine which plan is right for you. Whether you’re an individual, family, self-employed, or find yourself coming off of a group health insurance or a cobra plan, you’ll discover it’s easy to find an affordable health insurance plan that is right for you.

Never buy your health insurance plan based on price alone. If you do, you will end up with less benefits and higher out-of-pocket expenses. Remember, you never get more for less. Always make sure you understand what you are purchasing.

Here are some items to consider when purchasing individual health insurance in California.

How do deductibles and co-insurance maximums affect me?

The deductible is the annual out-of-pocket amount the consumer is responsible for before most major medical services are covered. The bigger the deductible, the lower your monthly premium will be.

After the consumer meets the deductible, the co-insurance applies to the policy. This is the percentage of covered expenses an insured individual shares with the carrier. A typical example of co-insurance is a 70/30 plan. This means the insurance company will pay 70% of covered expenses, and the individual will pay the remainder 30%. The co-insurance typically comes with a stop loss provision that will limit your annual out-of-pocket expenses on covered medical expenses.

Doctor visits

Doctor visits are not covered the same on all plans. Some plans have unlimited doctor visits for a co-pay amount, other plans have limited visits for a co-pay, and some have no visits covered till you meet your deductible. An important thing to consider is how often you go to the doctor. If you rarely go to the doctor, limited or no visits might be something you want to consider because this option will lower your monthly premium. If you have small children or visit the doctor often, then a plan with unlimited visits with a co-pay may be considered.

Annual Physicals

Annual physicals are covered differently from plan to plan. If you want your plan to cover your annual physical with a co-pay, be prepared to have a higher monthly premium. Not all plans offer this option, and many require you to satisfy a deductible before cost sharing is available.

Prescription Drug Coverage

Understanding your prescription drug coverage is very important. If you are currently taking medication, make sure it’s covered under your new policy.

If you are not taking any medication, you have several options here. Some plans offer no drug coverage, others only cover generic drugs, and some cover generic and brand name drugs. The plans with the least coverage are the most affordable, and the most comprehensive plans are the most expensive. Make sure you understand how the prescription drug coverage works on each plan, and remember that, typically, you can’t add coverage at a later date to cover prescribed medications.

Maternity Coverage

If you planning on have having children the maternity coverage is something you need to consider. Maternity benefits are always subject to the deductible and co-insurance. An important thing to remember is if you have an insurance policy without maternity coverage and you become pregnant you can’t add coverage.

For low to mid income families without maternity coverage the state of California does offer affordable option through Medical and Access for Infants and Mothers program (AIM). Call us to find out more about these options.

Still having trouble finding California health insurance coverage?

If you are still having trouble determining with health insurance plan fits your needs please feel free to call Fresno Health Insurance Services @ (559) 940-5930. We are here Monday – Friday 9am-6pm Pacific Standard Time. We will walk you through a brief screening process and make a professional recommendation of which health insurance coverage fits your needs. Or services are free and never cost you anything.