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California health insurance  -  California health insurance basics  -  Shopping tips for California health plans

Insider's Tips on Shopping for California Health Insurance

When you work exclusively in one market for almost two decades, you start to learn a few tricks..hopefully.

When you throw another 12 years of web experience in that same industry, everything takes on a definitely online slant. After helping 1000's of online shoppers, we sat back and asked what would be the best tips we could offer in trying to get the best California health quote for you, your family, or company?

We wanted the top concerns that would save you the most money while still providing you with solid coverage. Is that even possible on the today's market?

Yes and this why...many people we come across are on really bad plans or at least, bad in terms of value. Let's jump right into our top tips!
1. First, we want to make sure to see the best quotes available.

When you run your quote, use the age of the younger spouse as the primary since some carriers will quote based on this age (even though other spouse is younger).

We want to make an informed decision and reflecting the best rates is a start.
2. Go PPO or HSA.

HMO's plans on the individual family market are so expensive now that they almost never make sense unless someone else is paying your premium and even then... The cost can be two to three times that of a mid-level PPO plan. The numbers just don't work in your favor.
3. All plans cover maternity coverage effective July 1st, 2012.

Even older plans or the so-called "grandfathered" plans cover maternity as a core benefit due to California legislation. It's no longer a factor in which plan to choose.

We cannot exclude this benefit.
4. The two factors that probably matter most are deductible and max out of pocket.

These two numbers dictate how much you'll pay in case of large medical bills.

When running your quote, there are two benefit headings for "deductible" and "copay limit" (which is interchangeable with out of pocket max). Some carriers will show the max in addition to the deductible while others will show the max including the deductible.

For example, if deductible is $3K and ADDITIONAL max is $3K, some plans will show it as $3K and $3K while others (such as Shield's new plans) will show the exact same plan as $3K and $6K. This can be confusing. You can always click on the plan name to bring up the summary brochure which will specify this relationship. We can help of course go through any plan comparisons.
5. With all the plans that come up, there are really a few suites of plans that make any financial sense.

Today, it basically boils down between Anthem's Smart Sense plans and Shield Secure Wise plans for mid-level plans. Otherwise it's more catastrophic coverage (point #6 below). We can help you compare and contrast these for your situation. Furthermore, you have a choice of generic only or Brand RX for the Smart Sense plans.
6. For lower priced, catastrophic coverage, Anthem Blue Cross Clear Protection plans or Blue Shield's HSA plans are generally the best value on the market with the latter being more comprehensive (it's what I personally have). If price is the absolute qualifier for you, start here. Otherwise, look at #5 above.
7. California HSA health plans combine high deductible PPO plans with tax-favored checking accounts.

 If the tax benefit is sufficient (based on your tax bracket), Shield's HSA plans are generally priced better and they have an embedded deductible (in your favor).
8. Family members can be on different plans.

 You can mix and match plans within a family since each family member is individually priced these days. You may want richer coverage for children since adults cost more in most cases. You can mix and match benefits. Maybe catastrophic for adults and more comprehensive (office visits and RX coverage) for the children. Adults are more expensive than kids so this can work to your advantage.
9. There's a new rule regarding effective dates in that the earliest available is 15 days following online app submittal (completed) or hard copy being received. Applying online for California health insurance is always the fastest approach and you can access the applications through the quote or here. This gives extra reason to start earlier rather than later.
10. Payment is now required with the application (credit card or auto-deduction option) up front but we have a 10 day free look window in California which means we can cancel it the policy for any reason for a full refund with 10 days of their written offer. No application fee or fee for our service is required and the rates online are best available on the market.
So these are the big 10 that cover everything from picking the best plans to getting the best rates. There are many other concerns and questions since everyone has a different situation but that's where we come in with our 18 years of experience. How can we help?

Call us at 800-320-6269 with any questions.  Our services are free to you as licensed health agents.

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