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California health insurance  -  Top Topics  -  Affordable Health Coverage

How do you find Affordable California health insurance?

One of the most popular searches online is for "affordable" health insurance. What exactly does that mean and how can you find as an individual, family, or small business?

Deciphering Affordability

The exact meaning of "affordable" health insurance is a bit vague as "you get what you pay for" definitely applies to a product such as health insurance, but the sincere need to lower costs is critical in the market now. Health insurance premiums have skyrocketed since about 1997 with double digits increases each year. Affordable California health insurance has become "insurance I can actually pay the premium for". First, let's look at what is driving the cost of coverage.

We have covered what is driving the cost of healthcare in-depth on other pages listed at the bottom of this page. In a nutshell, increased utilization (higher use of medical services - especially diagnostic services such as MRI's), a major ramp-up in utilization and cost of brand name medications as a result of improving technology and direct-to-consumer marketing, and cost-shifting due to people using healthcare with no insurance.

Due to these effects, we have seen a 3-4 fold increase in premium with corresponding reduction in benefits.

The "affordable" rally call is simply a collective call of "Uncle!!" to this never-ending cycle of increasing costs.

California health insurance ratesThe "Affordable" Care Act or ACA

Now, affordability all depends on your income. With Covered California, the underlying cost of California health insurance goes up substantially but some people qualify for health subsidies if they make less than 400% of the Federal Poverty Level.  This is everything now on the individual and family market.  We have seen premiums as low $1/month due to tax credits.

If your income is under $46K for an individual (goes up for larger households), call us immediately and we can see what tax credit you may be eligible for at 800-320-6269.

PPO versus HMO health plans in California

PPO plans are the future of health care as HMO's have become extremely expensive. It's hard to justify an HMO plan unless a person absolutely wants low out-of-pocket expenses when sick or hurt...even at the expense of his/her monthly premium being much higher. This only holds true if you are younger. The premium difference between these plans and HSA high-deductible plans starts to erode their affordability as you get older.

Health carrier selection

The plans are now standardized by the ACA law so the differences we used to have between carriers is less pronounced.  A Silver plan is pretty much a Silver plan regardless of the carrier.  That isn't to say that there are differences in pricing among the carriers at a given level of benefit.  There are and it can be significant.  Why is that true if the benefits are the same?

Networks.

The carriers now have pared down networks and some are more narrow than others.  This can affect pricing significantly so make sure your providers accept a given plan/carrier before enrolling.  We can help with this process since the online directories have had issues.

Current affordable plans on the California market

  1. First, see if you qualify for a tax credit. That is paramount in today's health coverage world
  2. The Bronze and Silver plans generally make the most sense unless you have very expensive, ongoing medical needs
  3. Ask your doctors which "Covered California" plans they participate with. 

With these three questions answered, the choice becomes pretty easy.

Keep in mind that there is 2% of income penalty for not having health insurance in 2015 so that is NOT affordable. 
Related Pages:
Individual Family Health Insurance Center
Small Group Insurance Center

Covered California Top Questions

You can run your Health Quote here to view rates and plans side by side from the major carriers...Free.

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