Who Needs Individual Health Insurance?
Everyone in California should have comprehensive health insurance coverage. Comprehensive means that the plans comply with the Affordable Care Act and offer all of the required Essential Health Benefits.
People not covered by employer insurance
Freelancers & self-employed
Early retirees
Anyone needing comprehensive coverage
What options do we have to sign you up for health insurance?
Private Health Insurance coverage. Purchase a plan directly from one of the insurance companies, like BlueShield of California, HealthNet, Sharp Health Plan, etc. We can get you a quote from any one of these private insurance companies and review the benefits of the plans. This is not using the California Marketplace of Covered California so no premium assistance is available using this option.
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. For 2024 we can select from 12 Insurance Companies on Covered California, like Blueshield of California, Anthem Blue Cross, HealthNet, Sharp Health Plan, Molina, and Kaiser Permanente.
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If your income is below a certain amount and you can qualify for Medi-Cal, we can give you information related to the income guidelines and help you apply through Covered California but the Medi-Cal Program is run by your Local Health and Human Services office.
Keep in mind most people are eligible for Medicare, the Federal Health Insurance program when they turn 65, some people under 65 may also be eligible due to disability. See our Medicare page for more information.
When you're in the process of selecting a plan from Covered California, there are several factors to consider
Monthly Premiums
Your monthly premium is the amount you pay for your plan every month. Generally, higher premiums correspond to lower out-of-pocket costs, while lower premiums mean you might pay more for care when needed.
Deductibles
he deductible is the sum you're responsible for paying before your insurance coverage takes effect. Plans with higher deductibles often feature lower monthly premiums, though exceptions exist.
Copayments and Coinsurance
Copayments are fixed amounts you pay for various healthcare services, while coinsurance represents a percentage of the total cost of care. Understanding these costs is essential for managing your overall healthcare expenses.
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Network
Health insurance plans come with networks of healthcare providers. It's crucial to confirm whether your preferred doctors, hospitals, and clinics are part of the plan's network to ensure you can access the care you prefer.
Prescription Drug Coverage
Evaluate whether the plan covers the medications you require and if any restrictions or hurdles exist in obtaining them.
Out-of-Pocket Maximum
This represents the maximum amount you'll pay out of your own pocket for covered healthcare services during a plan year. Being aware of the out-of-pocket maximum is essential for financial planning and preparedness in case of unforeseen medical costs.
These factors collectively play a significant role in determining the cost and accessibility of your healthcare, making it crucial to weigh them carefully when selecting your Covered California plan. We can help you through the process.
Why should you use an insurance agent with your Cov CA plan?
Utilizing an insurance agent for your Covered California plan offers numerous advantages. These professionals provide expert guidance and in-depth knowledge, simplifying the often complex process of selecting a health insurance plan.
They can save you time, grant access to multiple carriers, and assist with subsidy applications, ensuring you receive the financial support you're eligible for. Beyond enrollment, agents offer ongoing support, assist with claims and policy changes, and provide objective advice in your best interest. Best of all, their services are cost-free for you. Working with an agent streamlines the process, guarantees informed decisions, and ensures you obtain the right health insurance coverage for your needs.