It's difficult to get excited about California health insurance but the closest we can come is regarding the Advantage PPO plans for Health Net. On the individual and family market,
Health Net changed their plan make-up in 2012 and they have been very popular ever since with a combination of the commonly the lowest cost plans on the market combined with solid coverage going into the big change coming forward with Health Reform. Let's look at the core benefits of the Health Net Advantage plans and why's it's so popular.
The benefits for the Advantage plans are actually pretty much down the middle of what's available on the market which is impressive considering its cost. You have a choice of two deductibles at $3500 or $6500. The plans work the same except for the deductible amount and of course, the monthly premium. The max out of pocket is $3000 more (above the deductible level). Essentially, you pay the first $3500 (with that deductible choice) and then you start paying 50% until you pay an additional $3000 for a total of $6500 for catastrophic big bills in a calendar year. That's pretty similar with most other plans on the market now. The deductible and out of pocket max are per person, up to two people in a family. Keep in mind that these benefits assume in-network providers and as with all PPO plans, you'll pay more for non-emergency out of network care with the Advantage plans.
You get two office visit copays at $40 per family member right away and preventative benefits are covered at 100% (not subject to the main deductible). The preventative benefit visits such as routine physical or annual pap/mammogram do not use up your two copays. After you use up your initial copays, office visits will be subject to the main deductible and then the 50% cost sharing until the max is met.
There are three tiers for the Health Net plan. Generics are available right away for $15 copays. Brand formulary and brand non-formulary are subject to a $2500 brand deductible (calendar year), you will get $40 or $60 copays respectively. The deductible resets Jan 1st as with all plans.
Diagnostic lab, Diabetic and Durable Equipment with the Advantage Plan
Similar to the Clear Protection $3300 health plans from Blue Cross, these benefits are carved out so that you will pay the full negotiated PPO rate until you meet the Out of pocket max ($6500 or $9500 depending on deductible choice). This make sense considering that diagnostic lab (think MRI, PET, CAT scans) have become so commonplace. In today's world, you're usually way under your deductible or way over your max out of pocket so were not as concerned with this carve out treatment on the Advantage plan.
Let's face it...the main criteria people have these days is just being able to afford health insurance at all. The Advantage plans are consistently some of the best priced individual and family health plans on the market. In fact, they are generally the lowest and we received word (though not confirmed) that a rate increase is not planned during 2013. This is all that matters since most of the current health plans will go away Jan 1st 2014 with health reform. When you run your quote, compare the Health Net Advantage plans with the Anthem
Clear Protection $3300 and the Shield Savings plans. Those are all solid options on the market while we wait to transition in 2014.
Related Pages:
Current best individual family California health
insurance plans
Catastrophic health plans in California
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