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an employee at a start-up company, I needed help finding a reliable
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If you are researching
California health insurance for the first time, it's best to start at the beginning:
California
Health Insurance (also known as health coverage or medical coverage) allows
you to pay a third party a monthly fee in return for free or reduced emergency
care, doctor visits and prescription drugs.
There are five major
health insurance companies in California that offer individual health insurance
plans -- Blue Cross, Blue Shield, Health Net, Kaiser Permanente, and PacifiCare.
You’ve probably heard both positive and negative things about each of
these health insurance companies. While these insurance companies all have their
pros and cons, one thing is certain: they are all large health insurance entities
with enormous bargaining power and can negotiate much lower doctor, hospital
and prescription fees than individuals can on our own.
There are
two key things you should consider when choosing California Health Insurance.
1) Quality of medical care: Consider
health care quality in the same way you would think about signal clarity with
a cell phone carrier. Before you pick an exact phone plan, you have to decide
whether to go with Verizon or T-Mobile. There is nothing worse than getting
stuck with a cell phone company that drops your most important calls and doesn’t
offer a signal in your own neighborhood. Similarly, it’s no fun when your
California health insurance company fights your request to see a dermatologist
or bogs you down with paper work. Of course the quality of the medical care
you receive will depend a great deal on your particular doctor or hospital,
but some insurance plans are consistently better than others. Fortunately, consumer
advocate groups such as Health Scope have surveyed and ranked the major insurance
providers. These ratings take into consideration important factors such as quality
of service, communication by medical staff, billing hassles, “red-tape”
and choice of doctors. Click here for a report
card of California HMO providers.
2) Extent of health insurance coverage:
Just as some people are willing to pay for comprehensive cell phone
plans that allow them to talk for hours on end, you can pay higher health
insurance premiums, and receive more extensive medical coverage. You must
determine what’s most important to you and what trade-offs make you most
comfortable. For instance, some plans might offer an attractively low monthly
bill, but in turn, they may only cover a portion of emergency medical visits
and nothing else. Other plans have higher monthly fees but will allow you to
visit the doctor and hospital whenever you want with very few additional fees.
Before you can decide what California health insurance plan is right for you,
you’ll need to understand the following four health insurance buzzwords.
a.Premium: Refers to your monthly health insurance bill. In
general, the higher the health insurance premium, the less you will end up
paying for B, C and D below.
b. Deductible:
Refers to the cash amount that you have to fork over before your health insurance
company is required to contribute. For instance, a $500 deductible means that
when you go to the hospital to have that hatchet taken out of your spleen,
you’ll have to pay the first $500; the health insurance company will
kick in the remaining balance.
c.Co-pay: Refers to the amount some plans require you to pay
toward the cost of a particular health service (e.g. $15 every time you see
the doctor).
d.Co-insurance: Refers to the percentage of fees you share
with your health insurance company. If you have 20% co-insurance, they pay
80% of the operation and you pay the rest. Many plans also have an out-of-pocket
maximum (e.g. $3500 per year) which will give you a general idea of the most
you would have to pay, should you have a particularly rough year at the crash-up
derby.
Look for these four
terms while reviewing California health insurance benefit information and you
will get an understanding of how much you will pay up front (premium) and how
much you will have to pay if you need medical care, (the other three). Remember,
if you elect a plan with a low premium you will usually pay significantly more
on deductible, co-pay or co-insurance fees if you wind up in the hospital. Regardless,
having a plan with a low premium and high deductible and co-insurance will still
help you realize a huge savings over having no insurance at all, should you
end up in the hospital. Think of low premium plans like those “Intro 20
anytime-minute” cell phone offers. They are great if you rarely use it,
but if you end up needing your phone more often, you’re better off with
a more comprehensive health insurance plan.
Remember
there are a few differences between cell phone plans and California health insurance
plans. Most notably, if you’re on your way to Hawaii and need to expand
your cell phone coverage, it’s no problem. If you are own your way to
the emergency room and need to expand your health insurance coverage, you’re
out of luck. Also, having health insurance doesn’t just safeguard your
health, it can help you avoid financial ruin if the worst comes to pass.
Blue Cross Tonik
Blue Cross has recently launched a new
group of plans called "Tonik Health" specifically targeting active young healthy
people who need health insurance but hate forms and jargon. Their goal is to
create fun, easy to understand plans that you can apply for in minutes. We were
skeptical at first since, as we all know, health insurance companies are notorious
for making everything more confusing than it needs to be. We were pleasantly
surprised to find out that we were wrong. Tonik plans are easy to understand,
easy to apply for and very affordable. Find out more about the Blue Cross Tonik
Health plans by visiting our Blue Cross Tonik Page or visit our Blue Cross Tonik
FAQ section.
So what’s
next?
Your next step is
to get a California health insurance quote and look at the plan benefits to
see what they charge for premiums, deductibles, co-pays and co-insurances. Click
here for a quick
quote with a link to benefit information. Still have questions? Call Medicoverage
toll free at (888) 285-MEDI, and we’ll help you pick the right plan for
you. Just don’t call us from the ambulance!
