California Health Care

If you need prompt medical attention, you have two main options — an urgent care center or the emergency room. The former is definitely the more affordable option, but in what situations is it applicable, and does health insurance cover these visits?

Urgent care centers typically treat patients with health insurance and those without, but the costs may vary significantly. While certain centers offer discounted rates to uninsured individuals, the amounts may still be high, depending on the treatment.

Urgent care is typically covered by insurance, but there are some factors to consider. When seeking an appropriate center, look for a facility that falls into your provider’s network. Some plans, like the preferred provider organization (PPO), typically allow you to receive treatment at a center outside of their network, but you may pay a significantly higher fee. Other plans, like the exclusive provider organization (EPO), only provide coverage for in-network facilities, except in an...

Posted: June 12th, 2024

Coinsurance, like deductibles and co-pays, are different types of out-of-pocket costs you may need to pay for health care services. Understanding these different terms and how to calculate them is essential for understanding your health coverage and getting the right costs ready in advance. Coinsurance is a beneficial cost-sharing option that allows you to share medical bills with insurance providers, making your health care costs more manageable.

This guide explores how coinsurance works, how it differs from other cost-sharing requirements like copayments and deductibles and how to calculate coinsurance costs. It also provides helpful examples of the different types your insurance provider might offer, where you can find your coinsurance structure and what to enquire about.

Coinsurance is when you pay for a percentage of health costs on your own. Your insurance plan will pay the other portion of medical costs after you meet the deductible. The deductible is the initial amount your...

Posted: June 5th, 2024

For years, Deferred Action for Childhood Arrivals (DACA) individuals could not receive discounts through Covered California. The latest health insurance news ensures that those eligible for DACA will be able to do so as of November 1st, 2024.

Learn more about this update and how to enroll with the Health for California team today.

DACA is a policy that is a lifeline for many undocumented immigrants who were brought to the United States as children. Specifically, this policy helps eligible individuals avoid deportation and receive a Social Security number, work permit and driver’s license to live and work legally in the States. DACA approvals are valid for two years at a time, with renewals for ongoing security and employment possibilities.

It is important to note that DACA differs from the traditional green card and its permanent citizenship. Instead, DACA acts as a temporary reprieve for several benefits, including status protection, valid IDs, education access, work authorization and...

Posted: May 29th, 2024

Choosing health insurance that meets your needs is one of the most important decisions. One option is catastrophic health insurance. This medical coverage is for people under the age of 30 and adults who meet hardship exemption requirements.

Catastrophic health insurance is limited to eligible individuals. If you do qualify, understanding the pros and cons can help you decide if it’s the right health insurance for you.

Catastrophic health insurance is an individual health insurance plan with high deductibles but low monthly premiums. These health plans cover you in worst-case scenarios like major medical diagnoses or significant injuries.

Before the Affordable Care Act (ACA) came into effect, the term “catastrophic coverage” was broad. People used it loosely to describe any health plan with high deductibles and limited coverage for routine medical needs. With ACA’s new health plan structures, catastrophic health insurance is a specific type of individual health plan not avail...

Posted: May 8th, 2024

Everyone has to have health insurance now that the Affordable Care Act (ACA) is in place, but that doesn’t mean health care has gotten any less confusing. We tend to go with what we know or what we’ve always had when it comes to insurance coverage, but the reality is that you have options.

In California, health insurance plan options primarily include Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO). Other options include Exclusive Provider Organization (EPO) and Point-of-Service (POS) insurance plans, which are growing in popularity in California.

While all of these plans can provide the coverage you need, it’s essential to understand each option and compare them. Failing to grasp the differences between HMO, PPO, EPO and POS plans could lead to significant unexpected costs and disappointment in switching doctors due to a change in insurance coverage. These plans provide coverage, but there are substantial differences in how the...

Posted: May 2nd, 2024

Health insurance makes medical bills easier to manage, but what about individuals and families in California with less financial stability? If you need medical care but don’t have the necessary funds, you might leverage a government subsidy for health insurance.

What is a subsidized health insurance plan, and how can you get one? This guide explores how these subsidies work, critical eligibility requirements and steps to get a health insurance subsidy.

A subsidized health insurance plan is a government-funded program that pays for part or all of your health coverage. There are two types available:

These subsidies are provided by the Affordable Care Act (ACA), otherwise known as Obamacare.

Your yearly income will typically determine if you qualify for a subsidy. You’ll need to estimate this income and compare it with those in the government’s Federal Poverty Level (FPL) guidelines. The amount you receive depends on your estimated income, modified adjusted gross income reported...

Posted: May 1st, 2024

Generally, health insurance for self-employed individuals is tax deductible. The deduction applies to self-employed workers, their spouses, dependents and non-dependents under the age of 27. However, the type of health insurance coverage also determines whether the tax deduction is allowed.

In this guide, you’ll learn about the various types of health insurance policies available to self-employed workers and how to know which one is tax deductible. You’ll also learn about the eligibility requirements and what disqualifies a person. Finally, we’ll cover how you file health insurance deductions and answer some common questions.

There are different types of health insurance for self-employed individuals, depending on the nature of the business. Are you working a temporary side gig or transitioning between jobs? Do you freelance or own a business? These factors can influence the type of coverage you should get, but here are some general examples:

Remember, the Internal Revenue Service...

Posted: April 24th, 2024

When signing up for a health insurance plan, you need to consider various out-of-pocket costs. Your deductible will typically be the most expensive cost, so it’s important to understand the difference between a low deductible health plan (LDHP) and a high deductible health plan (HDHP). The deductible that’s right for you will primarily depend on your health and financial situation.

Your health insurance deductible is the money you must pay for medical services before your insurance provider steps in. For example, if you have a $1,000 deductible, you will pay the first $1,000 of your medical bills out of pocket. After you pay the deductible, you will only have to pay a copayment fee on covered services while the insurance company covers the remaining amount.

Before choosing a health insurance plan, you must know all the potential costs involved. Discover what common health insurance terms mean below so you can make a more informed decision:

High deductible plans require yo...

Posted: April 17th, 2024

Vision insurance is a plan that covers specialized eye care, such as routine eye exams and prescriptions for correcting vision errors, subject to exceptions. It’s separate from your medical or health insurance, covering eye care expenses instead of general eye complications considered as medical issues. The specific coverage under vision insurance varies depending on the insurance provider and the terms of the insurance contract or policy. However, there are some standard inclusions. It’s important to review your plan to determine what it covers and the level of coverage it provides.

This guide discusses the standard vision insurance inclusion and exclusions. It also addresses the coverage you need if your vision insurance does not cover a condition or treatment.

Vision insurance coverage depends on the insurer and the plan you purchase. However, standard coverage includes:

You may get contact coverage on your medical or health insurance plan as an extra package. If your plan exclud...

Posted: April 10th, 2024

Caring for an older loved one involves demanding tasks like daily custodial care and household chores. These responsibilities can require a lot of mental and physical energy, necessitating occasional breaks to focus on self-care, relieve stress and ensure you are fully present when you return.

When you step away, the person who relies on you needs uninterrupted support from knowledgeable and caring people. If your loved one is a Medicare recipient, respite care coverage can fill the gap. Let’s explore the terms and benefits of respite care and the associated payments.

Respite care is a period that allows a primary caregiver a hiatus from looking after a patient or older loved one. Depending on your health care provider, this interval may last one afternoon or several weeks. Various people can provide respite services, including relatives, friends, professional caregivers, nurses and community volunteers.

The patient will typically spend this time in a hospital or similar facility that...

Posted: April 3rd, 2024

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.