You can run instant quotes all over the net but understanding what you get back is a different story. There are many different plans from a multitude of carriers presented. The first step is to understand the seemingly foreign language the quote is written in.
Health insurance rates are based on area and age at the individual and small group level. In California, gender does not play a role. Before you can get the rates, you will need to enter your residence zip code and the ages of those you wish to cover. After a few seconds, you will be see a list of health plans. Typically, the most popular plans (three or four) will come up with the option of expanding the plans by type of plans (PPO, HMO, etc) or carrier (Anthem Blue Cross, Blue Shield of California, etc) or certain ranges (deductible under $1000).
The plans are listed in ascending monthly premium amounts (far right). From left to right, let's go through a sample plan from Blue Cross. You can sort the plans by California health carrier, plan type etc at the very top. This helps to narrow such a large amount of information.
Type. Next you see the "Type" Column. This essentially means In-Network (such as PPO if a PPO plan) or HMO. HSA stands for Health Savings Account but most HSA plans are usually PPO or EPO. Benefits can be quite different in or out-of-network. You can get a good explanation of HMO versus PPO.
Deductible. This is the amount you must pay for medical services each year before your insurance begins paying. Usually office and prescription copays are not subject to the main deductible except for HSA plans and some lower priced PPO plans. Click on the "View Plan Details" to see what is subject to the deductible. You can also get more information on understanding how health insurance deductibles work.
Dr. Copay The portion of charges you pay to your provider for covered health care services in addition to any deductible. For example, $20 for an office visit. You can also get more information on understanding how copays work.
Inpatient Hospital Once you have met your deductible, you pay coinsurance for additional medical care. It is a percentage of the billed charge. For example, your insurance company might pay 60%, and then you would pay 40%. It is similar to a co-pay, but is a percentage instead of a dollar amount.
Rx Card This tells you if prescriptions coverage is included. You can click on the "View Plan Details" for more information. When you look at the details, you will see the copay amounts listed if applicable. The copay is the fixed amount you pay for medications. "G" means generic. For example, a plan might have a $10 copay for generic. "BF" stands for Brand Formulary (brand name drugs on the carrier's allowed list). For example, a plan might have a $30 copay. Sometimes there is a separate deductible for Brand Name drugs.
Maternity Maternity is covered on all ACA compliant plans now by law.
View Plan Details If there is a plan you are interested, make sure to check the details. For that page, you will also be able to download the actual carrier plan brochure and exclusions.
View Doctors & Hospitals You can check to see if your doctor and or hospital participates in a given plan. This is very important to make sure you get the most out of your plan.
Apply for this Plan Once you decide on your chosen plan, you can click on this button to gain access to the downloadable or online application. The link to the application page can always be found at the very top of the page as well.
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