California Health Insurance Prices
California is one of the states with the greatest variety of healthcare plans and insurance companies. This is great because it affords you a large number of choices when looking for the plan that is perfect for you. However, wading through this sea of endless options can prove a daunting task.
All of the major health insurance companies in California such as Blue Cross, Aetna, Blue Shield and Health Net, offer a variety of plans at widely divergent price points ranging from $40 a person per month to $400 dollars or more. Part of what determines these costs is the way the plans themselves are organized.
The following four major types of California health insurance plans each have their own way of organizing fees, as well as multiple expense levels. Since almost every health insurance company in California offers at least two of these types of plans, understanding how each of them works will help you to also understand why their prices differ so drastically.
Fee-for-Service plans
The most prominent fee-for-service plans in California are offered by a company called Celtic (although they also offer other types of plans). With a plan like Celtic’s the burden of costs is shared between you and the insurance company. This means that your insurance company only pays for an agreed upon percentage of your medical bills. You might pay 15% for medical procedures while the insurer pays 85%.
For example: if you go in to a surgeon to have you appendix removed an it costs $2,500, under a plan that pays 75% you would be required to pay the remaining $375. The portion of the bill paid by you is called a “copayment.” In addition to copayments you will also be required to pay a monthly fee called a “premium” as well as a larger fee yearly fee called a “deductible.” The amount of this payment is generally based on the size of your household and the extent of the coverage.
Fee-for-Service plans also usually have what is called a “cap” which is the highest amount that you will be required to pay for your deductible and total co-payments put together. For example: if you’re deductible is $250 and your “cap” is $2000 then once you have paid a total of $1,750 in co-payments that year your insurance company will pay your medical bills in full, including all procedures that are covered under the plan. The lower the amount of the cap, the better.
However, almost every health care plan differs in the amount and variety of procedures it covers, so before you go for the plan with the lowest fees, it’s a good idea to take a good look at whether or not the most essential procedures are covered under any given plan.
What is great, however, about Fee-for-Service plans is that they allow you a large amount of freedom. You are generally allowed to choose any doctor you would like and can switch between doctors at anytime. But freedom doesn’t come cheap. Even the least expensive fee-for-service plans run just shy of $200 per month for premiums alone.
Health Maintenance Organizations
(Better Known As HMO’s)
Under an HMO you pay a monthly premium which in theory covers all of your basic health needs, including X-rays, hospital visits, check-ups, surgery, etc. Unlike Fee-for-Service plans however, HMO’s are much more restrictive and often will only allow you to see doctors or other medical professionals that have an agreement with the particular HMO. Sometimes co-payments are required for services such as doctor visits, but they are generally much lower and more stable than co-payments regulated by Fee-for-Service plans.
In fact, HMO’s are likely to be less expensive than Fee-for-Service plans in general. HMO’s also have a better reputation for providing preventative care; this is in the best interest of HMO’s as if they are able to prevent serious medical problems early they can save themselves a great deal of money later.
One of the most popular HMO’s in California is Kaiser Permanente, who are also one of the least expensive with some plans as low as $85 a month. Generally speaking however, HMO’s usually charge premiums that are at least $100 a month and upwards to $400 per month.
Point-of-Service Plans (POS) and
Preferred Provider Organizations (PPS)
POS plans and PPS’s are essentially a compromise between HMO style plans and Fee-for-Service plans. Just like in an HMO, a POS or PPS will assign you a primary doctor or network of doctors who will provide you with most of your care.
However, with a POS or PPS you will also be able to receive treatment from other doctors for an increased co-payment. Premiums for these sorts of plan usually cost anywhere from $40 to $300 depending on the level of coverage.
Occupying a sort of middle of the road these plans are generally carried by the largest variety of California insurance companies including Blue Cross, Health Net, Aetna, and Celtic.
Health Savings Account (HSA)
This could be described as a “do-it-yourself” insurance plan. In a way it’s not even really insurance at all. You are required to pay a certain amount of money into the plan every month and this money accrues nontaxable interest. Money is taken out for medical expenses when necessary and you decide what treatments you think are necessary.
Start Comparing CA Health
Insurance Prices Now!
Chances are you didn’t even know you had this many choices for California health insurance, but now that you have a rough idea of what is available, make sure you weigh each the pros and cons of each plan carefully in the balance.
You can easily compare CA health insurance quotes with oure free California health insurance quote tool located at the top of the page.
Start finding CA health insurance quotes now!