California Health Care

Planning a wedding, getting married and going on a honeymoon are unforgettable milestones. As you begin your new life with your spouse, plan for post-wedding needs like managing your finances and health insurance. You have several options and decisions regarding your health insurance after getting married. Will you join your spouse’s plan, keep your coverage separate or get a new plan altogether?

Understanding what considerations to make will allow you and your spouse to make the best and most cost-effective decision for your new family.

Outside a qualifying life event, you can typically only enroll in a new health plan during the open enrollment period, which often runs over the fall and winter months each year. However, marriage qualifies for a special enrollment period that allows you to sign up for coverage at other times of the year. The SEP allows you to change your health plan within 60 days after your wedding.

Getting health insurance for newlyweds can happen relatively quick...

Posted: September 20th, 2023

The birthday rule insurance policy is used by many health insurance companies that want to provide consistency and coordination of benefits across various policies. For parents with a child listed as dependent on both plans, understanding the birthday rule can help them determine who is responsible for payments. Explore what the birthday rule for insurance means and what exceptions might apply.

The birthday rule for insurance helps parents and health plans determine which policies are responsible for payments. The rule was created by the National Association of Insurance Commissioners (NAIC) and is used by many insurance companies today. It applies to children listed as dependents on both parents’ insurance policies.

According to the birthday rule, primary coverage is given by the parent’s plan whose birthday comes before the other. While birth years are not considered, the day and month of a parent’s birthday determine the coverage. The parent whose birthday comes second in the...

Posted: September 13th, 2023

Among American adults aged 70 and older with age-related hearing loss, only 30% have ever used hearing aids. Confusing health coverage and policies can make it challenging for seniors to get the medical attention and resources they need.

Medicare does not cover the cost of hearing aids or any associated costs, like fittings or follow-ups with audiologists. Those with Medicare Parts A and B will need to pay out of pocket or find an alternative way to cover the cost of this type of medical treatment.

Medicare will cover the cost of hearing tests that might determine if you need hearing aids. However, these tests must have a physician or primary caregiver referral.

Many people opt into Medicare Advantage when they sign up for Medicare. Also called Part C, Medicare Advantage is a program offering supplementary coverage from private providers. It helps fill the gaps in traditional Parts A and B, so policyholders can receive more comprehensive coverage that better meets their needs, like vis...

Posted: September 6th, 2023

If you’re starting a new job, your employer might offer you a grandfathered health plan. This health insurance type comes with many differences and considerations from other kinds, so knowing more about it can help you decide if it is for you.

A grandfathered health plan is a health insurance policy purchased on or before March 23, 2010, when the Obama administration instated the Affordable Care Act. This health care legislation aims to increase protections and accessibility to insurance. However, ACA also allowed some health plans to continue covering people, even if they do not meet all the act’s requirements.

There are two types of grandfathered health plans.

The insurance providers of grandfathered health plans must also follow specific guidelines under ACA to maintain their grandfathered status. Providers cannot significantly cut available benefits. Policyholders must have the necessary protection and coverage to receive diagnoses and treatment for conditions. Further, they can...

Posted: August 30th, 2023

Seeking a second opinion may help reassure you about your diagnosis or explain your symptoms better. Looking for a different doctor’s opinion is very common and can make the diagnosis process more manageable and help you move forward with confidence. Explore what a second opinion means and whether health insurance covers it.

second opinion occurs when a patient does not immediately accept a medical diagnosis. Many diagnoses may be hard to accept, especially those that imply a low quality of life or a reduced life expectancy. Sometimes, you may trust your doctor but would appreciate another look to be entirely sure. A second opinion offers peace of mind and helps you trust in the prescribed treatment and management of your condition.

Consider a second opinion if you:

A doctor may diagnose a serious illness, recommend life-changing surgery or offer treatment for your condition. Whatever the case, it’s important to make the best decision for you and your wellness. A second opinion co...

Posted: August 23rd, 2023

Navigating types of health insurance in the U.S. can be challenging. Some plans offer low deductibles and limited coverage, while others are more flexible but require higher premiums. Explore the five main types of health insurance, other options you might take advantage of and where you can search for new plans.

Examples of health plans in the United States fall into five categories — HMOs, EPOs, POSs, HDHP and PPOs. Explore each type to determine what might fit your needs.

health maintenance organization offers care from doctors, providers and hospitals within your plan’s network. You must get referrals from your primary, in-network care physician before seeing a specialist or outside health care provider. This insurance plan may not cover services without a referral, leaving you responsible for out-of-pocket costs.

Some advantages of HMOs include the following.

Here are some disadvantages of HMOs.

An exclusive provider organization uses in-network doctors except during emergenc...

Posted: August 16th, 2023

Employers often opt for consumer-driven health plans to combat the rising cost of health care. In turn, consumer-driven health plans may be the insurance plan of choice for employees because they offer lower premiums.

Before choosing this insurance plan, it’s essential to understand what it is and weigh the advantages and disadvantages. While the saving on premiums may appear advantageous, this plan is only ideal for specific individuals. To help you make the right choice, we’ll look at what a consumer-driven health plan is, its pros and cons and how it works.

A consumer-driven health plan (CDHP) is a health insurance plan that allows employers, employees or both parties to put aside pre-tax money to pay for qualified medical expenses not covered by the employee’s health plan. A CDHP links to tax advantage savings account such as a health savings account (HSA), flexible savings account (FSA) or health reimbursement account (HRA). This account helps participants to save money to co...

Posted: August 9th, 2023

As the cost of health care increases, many businesses are turning to health incentive accounts to help mitigate medical expenses. A health incentive account helps employers keep their employees healthy while decreasing medical bills. By offering employees a reward for staying on top of their health and well-being, employees become more aware of their health habits and empowered to make better choices.

Health incentive accounts offer a cost-effective solution to address the rising cost of health care insurance while focusing on the productivity and health of employees. Let’s look at what a hia account is, how it works and the benefits employers and employees can enjoy.

A health incentive account (HIA) is a reimbursement account sponsored by employers that financially rewards employees for completing healthy activities. An HIA allows employers to provide tax-deductible wellness care to their workers. When staff members make healthy choices, they earn credit that they can then use to cov...

Posted: August 2nd, 2023

Say goodbye to long commutes and crowded waiting rooms — telehealth appointments are revolutionizing health care access. Telehealth has become increasingly widespread with a telemedicine market forecasted to reach $460 billion by 2030. Virtual visits offer a convenient way to connect with health care professionals from the comfort of your home.

Preparing for a successful telehealth appointment is essential. Discover how to do a video visit with your doctor and learn about insurance coverage for these appointments for a seamless televisit experience.

A telehealth appointment is a remote health care visit that allows patients to connect with health care professionals using technology. Instead of physically visiting a doctor’s office, these appointments occur over video calls, phone calls or even messaging platforms. This flexibility empowers patients to receive medical advice, diagnoses and treatment plans from the comfort of their home.

How do telehealth appointments work? Patients...

Posted: July 26th, 2023

Health insurance agents serve an important purpose. They help consumers understand all of the complexities of health care and insurance. With a health insurance agent on their side, consumers can better understand their health care benefits and the enrollment process.

Health insurance agents have many responsibilities, though their primary job is to serve consumers like you. Whether you’re uninsured or are exploring your coverage options, here are a few ways a health insurance agent can help you.

Insurance agents act on behalf of one or more insurance carriers to service and sell insurance plans. This means they’re extremely knowledgeable about various health insurance providers and their plans. Each person’s health insurance needs vary, so there’s no one plan for everyone. But how do you know which plan is right for you?

Health insurance agents can help you compare various health plans with different carriers to find one that meets your needs and budget. Understanding what each...

Posted: July 21st, 2023

Not sure how Obamacare affects your health care plans in California? Learn how the ACA works in California, including benefits, costs and enrollment.

Covered California is the Golden State’s official health exchange marketplace where individuals, families and small businesses can find high-quality, low-cost California government health insurance.

Learn about Obamacare income guidelines in California using our income limits chart, and see if you’re eligible for government assistance.

Learn about the Covered California website. Find easy online enrollment. Set up your account, log in, buy insurance and more on the California health marketplace website.