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California Health Care

Find latest news, legislation and regulations related to the California health care system. Medical coverage services in the golden state are offered through the following options:

  • Covered California: The Health Exchange Marketplace
  • Insurance Carriers: providing off-exchange medical benefits
  • Veterans Administration (VA) Health Care Coverage
  • Medi-Cal
  • Prison Health Care for California

Health care in California has gone through radical changes since the passage of the Patient Protection Affordable Care Act (PPACA) in 2010 and the implementation of Health Care Reform in 2013. Obamacare plans in California are sold through the state health insurance exchange, Covered California.

Individuals, families and businesses can enroll on a health care plan through Covered California, through Medi-Cal, through a health insurance broker, or by contacting a health insurance carrier directly. Popular carriers offering health insurance in California include Anthem Blue Cross, Blue Shield of California, Kaiser Permanente, Health Net, Molina and United Healthcare. For rates and benefits, click California Health Insurance Quotes. Open Enrollment 2017 is from November 1, 2016 to January 31, 2017. Outside of that window, you may apply during the Special Enrollment Period as long as you have a qualifying life event.

Government agencies that regulate health care in California include the California Department of Insurance, the California Department of Health Care Services, the Department of Managed Health Care (DMHC) and Ombudsman. The DMHC and Ombudsman offer protections and legal assistance for the consumers of health care in California.

 

Obamacare requires that most Californians enroll in a health insurance plan or face tax penalties. Many Californians buy their plans through Covered California, but the state-run health insurance exchange isn’t the only option. You can purchase health insurance outside the marketplace.

People who qualify for subsidies benefit a lot from buying through the exchange. But if you’re not eligible for lower premiums on a health plan because your income is above 400-percent FPL, selecting health insurance outside the marketplace is logical. (more...)

Posted: February 7th, 2018

Everyone has to have health insurance now that the Affordable Care Act is in place, but that doesn’t mean healthcare 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). There is also a third option, Exclusive Provider Organization (EPO), which is growing in popularity in California.

While all of these plans can provide the coverage that you need, it’s important to understand each of them individually and then compare them to one another. Failing to grasp the differences between HMO, PPO and EPO plans could lead to significant unexpected costs and disappointment in having to switch doctors due to a change in insurance coverage. These plans provide coverage, but there are substantial differences in how they work and how much they cost.

Whether you’re without insurance coverage and looking to purchase a plan shortly or are just exploring the options you have as a Californian, we’ve provided some insight to HMOs, PPOs, EPOs and Kaiser Permanente. (more...)

Posted: December 28th, 2017

Healthcare in the United States has seen a lot of changes in the past few years, with prices for coverage fluctuating dramatically and the very platform for healthcare hanging in the political balance. This issue comes at a time when our country is still recovering from a devastating economic recession, and financial uncertainty and fickle premium costs are prodding many Californians to look for alternatives to health care coverage.

Many questions remain unclear to the average buyer. Are there penalties for not having health insurance? Is health insurance a requirement in California? If I can’t afford health insurance in California, or I don’t want to pay for health insurance, what are my options?

In this article, we will explain the risks of not having health insurance in California and other places, as well as how to better understand the healthcare system so that you won’t have to go without it. (more...)

Posted: December 21st, 2017 under Obama Health Care

by Wendy Barnett

Covered California Silver Plan’s May Receive a Rate Increase for 2018

Be on the watch for Covered California announcements in October or November 2017 regarding rate changes on the Silver Plans, or more specifically the “cost-sharing-reduction (CSR) surcharge.” Covered California already announced their proposed rates for 2018 which will have a weighted average increase of 12.5%. However, in addition to this rate increase, there may be a surcharge on all Silver Plans. This has to do with whether or not the federal government will make an annual commitment to funding CSR plans as was done since the Affordable Care Act (ACA) was passed. (more...)

Posted: September 29th, 2017 under Covered California Insurance

by John Hansen

Anthem’s EPO Gives Blue Shield the Winning Edge

Blue Shield of CA Maintains the PPO and thus the Image of Being the Carrier Who Offers “Choice”

What’s an EPO? That was the big question for many consumers during the 2017 Open Enrollment Period in California. It made consumers uneasy, and it caused many to switch from Anthem Blue Cross Covered California to Blue Shield Covered California.

Anthem Dropped Out-of-Network Coverage

Yes, there is a difference. Anthem stopped offering out-of-network coverage. And, for many Californian’s who want choice, they felt they would be limited by this.

Whether you go with Anthem or Blue Shield, it most often makes the most sense to stay in network. Your out-of-pocket costs remain so much lower when you stay in-network.

Anthem was losing money on their out-of-network coverage offered by their PPO’s so they made a gutsy move to switch all their individual and family plans over to EPO’s and stop offering out-of-network coverage. But they may have made a mistake. (more...)

Posted: August 18th, 2017 under Anthem Blue Cross California , Health Plans in California