Best Individual Health Insurance California - You will find the lowest prices for medical care. Depending on your income and the size of your home, you may also be eligible for federal reimbursement through the Affordable Care Act. Our prices can't be beat.
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Best Individual Health Insurance California
Everyone should have health insurance now that the Affordable Care Act is in place, but that doesn't mean health care has become a mess. We tend to go with what we know or have always had when it comes to insurance, but the reality is that you have options.
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In California, health insurance options mainly include Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). There is a third option, the Exclusive Provider Organization (EPO), which is growing in popularity in California.
While all of these plans can give you the information you need, it's important to understand each one individually and compare them to each other. Failing to understand the difference between HMO, PPO and EPO plans can lead to unexpected expenses and the frustration of switching doctors due to changes in insurance. These goals provide support, but there are significant differences in how they work and how they cost.
Whether you don't have insurance and want to buy a plan soon, or you're just exploring your options as a Californian, we've provided information on HMOs, PPOs, EPOs, and Kaiser Permanente.
Of the three types of plans - HMOs, PPOs, and EPOs - you have HMOs and PPOs at two different ends, with EPO plans somewhere in between. You should first understand the difference between HMO and PPO plans. Then you can see where EPO comes in, as a hybrid of the other two.
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HMO plans primarily revolve around a primary care physician (PCP). Your PCP is the doctor you go to for annual physicals or when you get sick. You can choose your PCP, but they must be in the HMO's group of health care providers. Here is more information about HMOs:
But what happens if your PCP doesn't think you need more treatment? Or that your illness does not allow you to visit a specialist? This can happen and you should consider it. As long as you choose a PCP you trust, this shouldn't be a problem.
All of your health care is covered by your local network - if you see an out-of-network provider, you're responsible for paying out-of-pocket costs. If you have a doctor you love, are waiting for an insurance change, and are considering an HMO plan, make sure your doctor is in the HMO plan's network. If not, you must change doctors to have a PCP that is in your plan's network.
There is an exception to the HMO network rule. You might be wondering - what if I'm on vacation and have an emergency? In this case:
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Overall, the HMO network is small, but there are two advantages to the HMO plan - both in the budget category. As long as you are working in an online HMO, you will not need to file a claim. Instead, your insurance company works directly with health care providers. Also, HMO plans almost always cost less - they often have low monthly premiums and no out-of-pocket costs.
Of course, this means that PPO plans, which are on the other end of the spectrum, are always more expensive – however, the added value comes in flexibility and flexibility. Internet is available, but you have the right to switch to providers outside your network if you wish:
With a PPO plan, there is more flexibility in choosing a PCP and seeing specialists. If you have a PPO plan, you don't have to have a PCP and can go see any provider you choose, but in the end you'll save money by choosing an online doctor.
You don't need to ask your PCP for a referral if you want to see a specialist - that's a decision you're free to make without seeing your PCP first. You may choose to see a specialist outside of your network because you can do so in a PPO plan.
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With all that flexibility and freedom comes a higher cost and a higher level of involvement in your health care, as you often spend more time coordinating, while a PCP takes care of most of the HMO plan. If you choose to see a doctor outside of your network, you may also need to collect information and submit a claim to your insurance company to cover some of the costs.
There are many differences between HMO and PPO plans, and there is no one-size-fits-all solution. What is best for you ultimately depends on what you like.
There is a third option that is gaining popularity in California - the Exclusive Provider Organization (EPO). This third option is a hybrid of HMO and PPO plans. You will have many of the rights you have with a PPO plan. Here is a list of EPO plan features:
Since you only use a dedicated network with an EPO plan, it is often less expensive than a PPO plan, making it a great deal for those who want to manage their health care without paying more. Again, you need to know if your doctor and the specialists you see are in the network or not, because you will be responsible for all costs if you go to a doctor outside the EPO network.
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California is home to the nation's oldest and largest HMO, Kaiser Permanente. Founded in 1945 and based in Oakland, California, insurance provider Kaiser Foundation Health Plan, Inc. serves people in California, Colorado, Georgia, Hawaii, Virginia, Maryland, Oregon, Washington and the District of Columbia.
The organization also supports Kaiser Foundation hospitals and The Permanente Medical Group, Inc., a physician group of more than 9,000 physicians. Kaiser Permanente created its own branded network.
As an HMO, Kaiser has a California provider network that includes PCPs, laboratories, hospitals and pharmacies. If you live in an area that doesn't have a Kaiser location, you can get care from a Kaiser partner -- they don't have the Kaiser name, but are considered part of the Kaiser network.
The Kaiser network currently serves more than 8 million Californians through 15,774 physicians, 467 medical offices and 36 hospitals located in northern and southern California. You can view Kaiser sites through an online search.
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You may have heard of Kaiser Permanente's campaign called "Winning." The cleanliness campaign emphasizes preventive care and includes, among other things, access to 24/7 nurses, disease control programs, healthy lifestyle programs, and discounts on fitness classes and programs.
In some ways, Kaiser Permanente is taking HMO plans to a new level by having its own medical groups and hospitals at its core, rather than merging with different health systems. However, it is still an HMO plan at its core and therefore comes with the limitations that define an HMO plan - you have to be in-network and manage all of your care after seeing a PCP first.
The first step is to look at your options - not all three plans are offered everywhere, so it's best to start looking at what's available to you. You can start by writing simple facts about yourself and your family, if any, on our website.
If you request a free quote, you will have a list of options, including the type of plan (HMO, PPO, or EPO). Once you know what plans are available, you can start looking at your priorities.
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There is no one-size-fits-all plan, but a plan that will work best for you and your family. Think about how important each of these things is:
As you consider your options, remember that each of these types of insurance in California will provide you with the health care you need. The way they go about providing these services just looks different. Individuals and families come in all shapes and sizes - and so do insurance plans.
Now that you have information about HMO, PPO, and EPO plans, as well as an explanation of Kaiser Permanente's approach, you are ready to find insurance. Whether you don't have insurance and need help or want to make a purchase, we have an online tool that allows you to get a free insurance quote instantly. You won't get a chance to see them all
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