With all the standardization created by the ACA law, there's still so much to consider when comparing the Covered California Plans.
In fact, it deserves even more research now with a hefty dose of tax and income info figuring into the mix.
First, our credentials as Certified Covered California Agents:
Let's break down the really important concerns in order to find the best value among the Covered California plans.
You can always compare the plans with tax credit here:
To make it ease, we've ranked the top 10 Tips!
First, we want to see if we can get a tax credit as that directly affects the pricing of ALL plans.
It is tricky to do it yourself. Well...to do it correctly.
This is doubly-bad. You either pay too much or have to pay back potentially $1000's next April at tax filing.
Both bad outcomes.
Everything that matters about Covered California is BASED ON INCOME!
How much you pay. What benefits you can get. Income.
Email us and we quickly size up what tax credit you're eligible for in 5 minutes
Many people who are eligible for a tax credit in Covered California are also eligible for an Enhanced Silver plan.
They're impossible to beat by going up to a Gold or Platinum.
This is the easiest decision on the market and guess what access to the Enhanced Silver plans is based on? You're right. Income.
You can look at the Bronze to reduce cost but you're losing significant (free) benefit enhancements.
Silver 73 should be compared based on your health and budget. We can help there.
Then, we need to look at 3 critical criteria:
All of these are very important and figure into the decision. The first two concerns are very familiar to us since we've been helping people quickly compare the options for 25+ years now.
The latter really became important after Jan 1st, 2014 since the new networks are about 2/3rds the size of the old plans.
Also, many hospitals now only contact with certain plans.
These three points take up the majority of the Covered California plan comparison but we can quickly hit the important points at 800-320-6269
So we run our Covered Ca quote and have all the plans in front of us. We're not offered the Enhanced Silver plans. Now what?
Here's where we roll up our sleeves.
We've broken up the Covered Ca plan details in more detail but the quick bullet points:
We have literally compared 1000's of plan options for people so it comes pretty quickly to us but here's the basic calculus.
Within a given carrier (Anthem for example) and network (EPO for example), look at the premium difference as you go up the scale (Bronze, Silver, Gold, and Platinum) per month.
Multiply this monthly difference by 12 (full annual difference) and then compare against what you're gaining in benefits.
Also, make sure to take into account what you expect in terms of health care needs.
You can use our new PlanFinder for a step by step walkthrough here:
This is important for people that travel or live close to another State where doctors might be just over the State line.
Make sure it's an emergency. For example, check pains that turn out to be indigestion and not a heart attack may pose problems when the claims come in.
Right now, only Anthem's EPO plan has access to
the Blue Card for out-of-State. Check with us as this can change.
Preventative is covered at 100% on all plans but only in-network so make sure your doctors participate or be prepared to use other doctors for your preventative.
Even the Bronze covers preventative this way.
If all you do is basic preventative on average and you're not offered the Silver 87 or 94, Bronze becomes an option to keep your costs down AND AVOID THE PENALTY.
Expect the following to fall under the preventative benefit banner:
It's not generally an issue but make sure the labs are also in-network to maintain your 100% coverage.
If the pricing is really low for one plan, that may be due to a smaller network (think hospitals) in your area.
If one carrier is significantly lower than another carriers, check with us. It may be a network issue.
Once we're out of Open Enrollment, we will probably not be able to change plans/carriers unless we have large life changes. We'll have to stay on the plan until January of the following year.
For that reason, it's important to make the best decision now to keep your costs down.
Now, there will be pricing differences between HMO, PPO, and EPO but giant swings should invoke some caution (and a quick question to us at help@calhealth.net )
Mental health coverage for most common diagnosis is treated as if medical so you look at the specialty copay and medication copays.
If you have mental health needs, there are two important considerations to keep your out of pocket down:
We want copays for these services (again, assuming providers are in network). That starts with the Silver plan.
The Silver 87 or 94 of course would be great due to the low copays but you still need to check networks.
The drug formularies or list of allowed drugs are small now so double check that if you have medication needs.
When you run your quote below, click on "Find Doctors" next to any plan. That takes you get provider directory but you can see the link for Drug Formulary as well.
There are different copays based on type of drug: generally Generic, Brand Formulary, and Brand non-Formulary.
Speak with your doctor to see if generics are available. It can save you a great deal of money!
We also recommend price-shopping to local pharmacies prior to having the doctor issue it.
The pricing difference can really swing wildly. Your RX costs
will be subject to the main deductible with the Bronze. RX copays start with
the Silver plan and up.
It generally takes 5 minutes to find the right plan and 5 minutes to
enroll right through our
online (simplified) app.
That's not hype. Most people we help are shocked...yes shocked at how
easy it is. They have no idea what the standard process is like.
How can we help you? Again, there is absolutely no cost to you for our
services. help@calhealth.net or
800-320-6269 Today! Related Page:
Getting the most Tax Credit Again, there is absolutely no cost to you for our services. Call
800-320-6269 Today! 10. Finally, don't go it alone.
As Certified Covered California Agents, our services are free to you.
Quote Covered California health plans
with Tax Credit to view rates and plans side by side for both
carriers...Free.