California health insurance - Understand Health Quote
Health insurance is tricky and the trend going forward looks like more of the same. The new health reform application is 20+ pages and we've switched out health history question for financial health questions with the same effect.
Most people get stuck just trying to analyze
the various health plans and rates while running
their California health quote. This really is
the most critical step of the process so let's
see if we can simplify it.
Ultimately, our goal is to find the least expensive plan for the best coverage. Daunting, yes but understanding the quote is the way to get there.
We described in our Video Series how to start
the quote which you can find here. Once you're
in the system, you'll see a quote grid. This is
all the available plans and rates are shown with
their various benefits. You'll see the plans
listed by carriers alphabetically and then by
monthly premium (on the far side). At the top,
you'll find the major benefit headings and this
is where people usually get tripped up. We'll
start there since 90% of the decision is a
combination of these benefits and the monthly
premium.
The three basic plan types are PPO, HMO, and HSA.
We have extensive articles on all of these but we can quickly narrow the options. On the individual/family market, HMO"s have priced themselves out of the market. HSA plans use the PPO network for almost all plans so really, we're looking at PPO plan types. The HSA refers to a tax benefit available to those plan members.
This is the big one.
The plan deductible is single biggest driver of plan expense. Essentially, the deductible is an amount you'll pay before getting help from the carrier. You'll still get negotiated PPO rates but you're paying this first.
This is the amount you'll pay in-network doctors for the consultation only.
It's usually in the form of a copay (say $35). Keep in mind that some plans will only allow a few copays before the deductible kicks in. HSA plans make office visits subject to the main deductible.
Preventative benefits will be covered at 100% in-network for covered benefits.
This is the important item behind deductible.
It shows what you can expect to pay out of pocket for catastrophic health issues (think $50K+). Some carriers have it it addition to the deductible while others include the deductible.
Out of pocket maximums are usually per person up to two people in a family during a calendar year (Jan 1st-Dec 31st). This is true regardless of when the policy starts.
This generally shows the portion you will pay after the deductible is met.
It's usually a percentage which is called Co-insurance. For example, if you have $1K deductible, 40% coinsurance, and $3K max, if you get a $10K bill, you can expect to pay the first $1K (deductible), and then pay 40% of the remaining $9K until you hit another $3K.
Your true max out of pocket would be $4K (deductible plus Out of Pocket Max in this case). The co-insurance means less these days since people are usually way under the deductible or way over the max.
Of course, this the most important piece.
It's the monthly amount you will pay each month to keep the insurance force.
Let us help you find the best health coverage for the lowest premium. That's the whole goal of understanding your health quote after all.
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!