There was a time when a small percentage of the shoppers for California health insurance were looking for catastrophic or major medical coverage.
There was also a time (we promise) when health insurance was much less expensive than it is now.
You really didn't need to worry about having catastrophic only coverage then.
What a difference a decade makes.
Now, we're continuing a trend in which health insurance is quickly approaching catastrophic coverage by definition and it's not necessarily a bad strategy for health insurance in today's world.
Let's take a look at the current best options for catastrophic individual health insurance on the California market.
What we really mean by catastrophic coverage is protection for the really big bills.
This generally means less or no coverage for office visits, RX (brand name for the most part on the today's market), and perhaps lower labs until a high deductible is met.
This type of insurance makes increasing sense as a person gets older or rates go up...which is obviously the trend for all of us unless you've somehow managed to break the universals laws of time!
How do we evaluate the plans out there and determine if catastrophic makes sense and which plans best fit this approach?
Let's get into the actionable information for California shoppers.
When looking at catastrophic health plans, the best place to start is with the monthly premium and work your way up.
You can run your quote here:
Make sure to put in your income estimate for this year and # of household members (on exchange quote) to see if there's a tax credit available.
Find the lowest priced plans across the market (ideally looking at a few solid carriers) and then find the sweet spot between premium and the all important deductible/out of pocket max.
This combination number shows your annual exposure in case you get really big bills (i.e. catastrophic).
It is usually per person, up to two people in a family for deductible and max out of pocket.
Some of the HSA plans may have a big family deductible that one person would need to meet.
So what's the important consideration when comparing the plans?
Let's say you have a $50K bill for a surgery resulting from an accident.
What's your total exposure in a calendar year? How much are you saving annually by going up the scale?
That's the trade-off...exposure to medical expenses versus annual premium savings!
Important Tip! The max out of pocket is virtually identical for the Bronze, Silver, AND Gold plan!
To make this easier, let's look at some of the best options to compare on today's market.
The ACA law has changed everything in terms of catastrophic coverage since the plans are all standardized by the law now.
For individuals under 30, there is a catastrophic health plan we can get....but
Generally, the premium savings between the Catastrophic plan and the Bronze is not enough to justify the limited benefits that the Bronze give you.
Since the core Bronze benefits are the same across carriers, it then becomes a function of pricing and network.
You can quickly quote the ACA catastrophic bronze health plans on and off-exchange here:
Find out which "Covered California" networks your doctor participates with.
This is a big deal now. Hospitals as well.
You can see the providers through the quote above for a given plan but we're happy to help there.
You can ask your doctor if they take "Covered California" since they all know that name now and individual/family plans all use the same network.
What if you can enroll now (missed open enrollment and no special triggers such as loss of group coverage, marriage, birth, move, etc)?
What are alternatives to ACA bronze health plans?
There's always short term!
An alternative to the ACA health plans is short term health coverage.
Short term health bullet points:
Right now, we have IHC which partners with Blue Cross Blue Shield. You can quote/enroll in short term health here.
Of course, we're happy to walk through the different options for your situation especially with the benefits of HSA funding.
Keep in mind that preventative benefits and maternity are covered under all California health plans (except for short term).
Again, there is absolutely no cost to you for
our services. Call 800-320-6269 Today!
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20 years of experience in the California health insurance market has taught us one thing...Competent and experienced guidance is Invaluable
We can quickly (very important) size up your health insurance needs and clearly explain the options available to you. Our focus is finding the most coverage at the best cost to you.
We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.
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