Covered California Plans Explained! (How to Choose the Right Option in 2026) - Watch on YouTube
When you run your instant California health insurance plan quote, the first thing you will notice is the tremendous number of options.
It's almost too much.
How do you break down the differences and find the right health plan for you or your company. Below are a few key points to help you find the right health plan for your situation.
We have over decade's experience solely in the California health insurance market. We have seen carriers come and literally go both on the individual family side and the Small Group market. We have seen health plan carriers pull out of entire counties, radically change plan design and rates multiple times a year, and initiate some pretty questionable practices. Some of these carriers are no longer on the market and some are.
Stay with the best. Ultimately, the rates will be better as fly by night carriers and/or plans will explode due to poor plan design or under-pricing the market.
Anthem Blue Cross is arguably one of the strongest nationwide health insurance company.
For PPO plans, they are hard to beat.
Secondly, we would look at either Blue Shield (more for PPO) or Health Net (more for HMO).
Kaiser is strong, especially on the Small Group side but they are unique in that the doctors are employees of the insurance company as part of an HMO model. They compete mainly on price.
With so many plan options and price points, there's not much reason to stray from the first three. Over the next 5-7 years, their strength will only continue to gain momentum, especially with Cross due to investments they are making now in their business.
These keys are important to figure out first.
1. Networks.
The big deciding factor now between carrier
is their list of doctors and hospitals.
Ask your doctors which carriers they participate
with first..
2. HMO versus PPO.
Which one are you?
This is a key difference in the plans and you can quickly narrow the options.
3. Comprehensive coverage versus hospital plans. Try to stick with plans that are comprehensive. The carriers are introducing many new health plans that carve out benefits such as Brand name prescription and/or caps on services. We would recommend going with the lowest cost, comprehensive health plan. Usually, this is the HSA or Health Savings Account eligible plans. This is especially true as you get older...the annual premium savings will more than offset the higher deductible whether you use the plan or now.
If we can impart one thing to look at, it's this...the plan choices are really a question of treating the small to mid size bills (office copays, prescription copays, and lower cost items..say $500-$1000) and how it treats the big bill ($50,000 surgery).
Determine which is more important to you or find a plan that blends the two. The big bill is dictated by the Max out of Pocket. The smaller bills are reflected by copays and the deductible amount.
Ultimately, there are almost too many California health insurance plan options. Please let us help you understand your options. As nice as this summary may be, there are quirks and twists to each plan so it is best to speak with us. With a few questions, we can isolate a few health insurance plans that really work for your situation with the sole purpose of offering a comprehensive health plan at the lowest cost.
Other important topics:
Comparing Covered California plans
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!