If
you are researching health insurance for the first time,
it's best to start at the beginning: California
Health insurance (also known as health coverage or medical
coverage) allows you to pay a third party a monthly fee
in return for free or reduced emergency care, doctor visits
and prescription drugs.
There are five major health insurance companies in California
that offer individual health insurance plans -- Blue Cross,
Blue Shield, Health Net, Kaiser Permanente, and PacifiCare.
You’ve probably heard both positive and negative things
about each of these health insurance companies. While these
insurance companies all have their pros and cons, one thing
is certain: they are all large health insurance entities
with enormous bargaining power and can negotiate much lower
doctor, hospital and prescription fees than individuals
can on our own.
There
are two key things you should consider when choosing California
Health Insurance.
1) Quality of medical care:
Consider health care quality in the same way you would think
about signal clarity with a cell phone carrier. Before you
pick an exact phone plan, you have to decide whether to
go with Verizon or T-Mobile. There is nothing worse than
getting stuck with a cell phone company that drops your
most important calls and doesn’t offer a signal in
your own neighborhood. Similarly, it’s no fun when
your California
health insurance company fights your request to
see a dermatologist or bogs you down with paper work. Of
course the quality of the medical care you receive will
depend a great deal on your particular doctor or hospital,
but some insurance plans are consistently better than others.
Fortunately, consumer advocate groups such as Health Scope
have surveyed and ranked the major insurance providers.
These ratings take into consideration important factors
such as quality of service, communication by medical staff,
billing hassles, “red-tape” and choice of doctors.
Click here for a report
card of California HMO providers.
2) Extent of health insurance
coverage:
Just as some people are willing to pay for comprehensive
cell phone plans that allow them to talk for hours on end,
you can pay higher health insurance premiums, and receive
more extensive medical coverage. You must determine what’s
most important to you and what trade-offs make you most
comfortable. For instance, some plans might offer an attractively
low monthly bill, but in turn, they may only cover a portion
of emergency medical visits and nothing else. Other plans
have higher monthly fees but will allow you to visit the
doctor and hospital whenever you want with very few additional
fees. Before you can decide what California health insurance
plan is right for you, you’ll need to understand the
following four health insurance buzzwords.
a.
Premium: Refers to your monthly health
insurance bill. In general, the higher the health insurance
premium, the less you will end up paying for B, C and
D below.
b.
Deductible: Refers to the cash amount that you
have to fork over before your health insurance company
is required to contribute. For instance, a $500 deductible
means that when you go to the hospital to have that hatchet
taken out of your spleen, you’ll have to pay the
first $500; the health insurance company will kick in
the remaining balance.
c.
Co-pay: Refers to the amount some plans
require you to pay toward the cost of a particular health
service (e.g. $15 every time you see the doctor).
d.
Co-insurance: Refers to the percentage
of fees you share with your health insurance company.
If you have 20% co-insurance, they pay 80% of the operation
and you pay the rest. Many plans also have an out-of-pocket
maximum (e.g. $3500 per year) which will give you a general
idea of the most you would have to pay, should you have
a particularly rough year at the crash-up derby.
Look
for these four terms while reviewing California
health insurance benefit information and you will get
an understanding of how much you will pay up front (premium)
and how much you will have to pay if you need medical care,
(the other three). Remember, if you elect a plan with a
low premium you will usually pay significantly more on deductible,
co-pay or co-insurance fees if you wind up in the hospital.
Regardless, having a plan with a low premium and high deductible
and co-insurance will still help you realize a huge savings
over having no insurance at all, should you end up in the
hospital. Think of low premium plans like those “Intro
20 anytime-minute” cell phone offers. They are great
if you rarely use it, but if you end up needing your phone
more often, you’re better off with a more comprehensive
health insurance plan.
Remember
there are a few differences between cell phone plans and
California health insurance plans. Most notably, if you’re
on your way to Hawaii and need to expand your cell phone
coverage, it’s no problem. If you are own your way
to the emergency room and need to expand your health insurance
coverage, you’re out of luck. Also, having health
insurance doesn’t just safeguard your health, it can
help you avoid financial ruin if the worst comes to pass.
So
what’s next?
Your
next step is to get a California health insurance quote
and look at the plan benefits to see what they charge for
premiums, deductibles, co-pays and co-insurances. Click
here for a quick
quote with a link to benefit information. Still have
questions? Call Medicoverage toll free at 888.285.MEDI (888.285.6334),
and we’ll help you pick the right plan for you. Just
don’t call us from the ambulance!
