WHAT IS INDIVIDUAL HEALTH INSURANCE?

Individual health insurance is the coverage you purchase on your own, on an individual or family basis, as opposed to getting it through an employer. Affordable Individual Health Insurance in California can be purchased either through the State exchange called Covered California, or off-exchange. The primary advantage of using the State exchange is to qualify for a premium subsidy based on household income. Brokers and navigators are also easily available in every state to help you enroll. The extensive range of services available guarantees that there is something suitable for every individual need. Before 2014, one could purchase a private health insurance plan in California at any time of the year. But as of now, one can only buy individual health insurance in California during the open enrollment period, except for special circumstances.

• This kind of health insurance for individuals offers coverage only for the insured individual.
• The insurance provider covers certain medical costs of the insured based on the premium paid.
• Hospitalization- The policy covers hospitalization charges.
• Covers surgery costs, room rent, physician’s fee, and laboratory tests.
• The insured has to pay a pre-determined amount for certain health care services. This is known as co-payment.
• It provides coverage for critical illness.

 

WHY SHOULD YOU GET INDIVIDUAL HEALTH INSURANCE?

The Obama care mandate necessitates that most people obtain medical insurance coverage. If you are not already enrolled in a health plan that meets the Affordable Care Act minimum essential benefits requirements, you may need to shift plans.  Call our office to help determine if your plan meets the minimum requirements. The mandate requires most Americans and legal residents to acquire health insurance that meets the standards set by the Covered California Exchange. Those who do not get insured might face a penalty.

• In an individual health insurance plan, the insured alone earns all the benefits under the plan.
• The insured individual will earn the benefit of individual sum assured rather than the floating sum assured.
• Most suitable for people with higher health risks.
• Parents and immediate family members can be added to the plan.
• No restrictions on the maximum age for the members for the renewal of the policy.
• There is no need to worry about making more than one claim in a year since the plan caters only to a single person.

CATEGORIES (WHAT IS COVERED)

Private health insurance plans in California are classified under five major categories to make comparing them easier. The categories are divided according to the percentage of health care costs they pay, and they include the following health insurance quotes in California:

• Bronze 60 Plan: With this health plan, you need to make small monthly payments [some plans may offer coverage for checkups and preventative care.] However, payment increases a little bit if you need to see a specialist. This plan is particularly suitable for young people with no dependents. If you don’t expect to see the doctor much this year, then this might be the precise plan for you. Plan deductibles apply.
• Silver 70 Plan: This is a popular option because making affordable monthly premiums your plan covers all the basics and more. However, deductibles apply. This plan is ideal if you are someone who works hard to ensure your health is always in check.
• Gold 80 Plan: This is a superb, all-inclusive health plan. You will make modest monthly payments and have low out-of-pocket costs in case you see a specialist or visit a hospital. The best thing is that you’ll have a lower deductible to meet, this may save you a lot of money in the long run.
• Platinum 90 Plan: With this health plan, you will make higher monthly payments, and receive regular physician visits, emergencies, and preventative care, in some cases without having to meet a deductible. It’s a great plan for individuals and families looking to save on out-of-pocket costs when the plan is utilized.
• Catastrophic – These plans are exclusively for younger people or those experiencing financial hardship. These plans pay a reduced percentage of your health care costs.

MEDICARE HEALTHCARE IN CALIFORNIA: AT A GLANCE

• More than 10 % of all Medicare recipients live in California, but only about 15 % of the state’s population has Medicare coverage, as opposed to more than 18 % of the US population.
• Medicare Advantage plans are not available in 18 of California’s 58 counties as of 2019.
• 43 % of California Medicare recipients are registered in private Medicare coverage — typically Medicare Advantage plans.
• 28 insurers offer Medigap or PPO plans in California, and more than half a million people have Medigap coverage in the state. Medigap insurers are obligated to offer coverage to people under 65 if they are disabled.
• California residents can choose from among 30 stand-alone Part D prescription drug plans in 2019, with premiums ranging from a very affordable rate to a higher rate if you choose a plan with no deductible or need a wider variety of drug coverage.