The identification of a decent health insurance plan has been like trying to identify edible mushrooms. So many mushrooms look the same: white stem with a cap on top. If you pick the wrong mushroom for dinner it could kill you, just like health insurance. Covered California has created some booklets, or field guides, to help people spot and identify the best health insurance for their family from within the new health insurance market place opening October, 2013.
Field guide make identification easier
Scientists love to classify plants into different groups for easier identification. California’s new health plans can also be classified for easier identification. Just like the plant kingdom, Covered California plans neatly fall into the family, genus and species taxonomic groups. The classification helps us “hunter and gatherers” quickly identify which type of plans we should focus our binoculars on.
Family of Covered California Health Plans
There are different varieties of health insurance represented in the Covered California family of plans.
Some of the common traits among all the health plans offered will be
- 10 Essential Health Benefits
- Standard Benefit Design
- Metal level designations corresponding to overall plan coverage
Genus classification
All of the plans offered for 2014 will fall under the category of
- Individual and Family
- Pediatric Dental
- Small Group SHOP
Individuals, families and small groups will follow the categorical path for the plans to find the health plans.
Species level
There is a tremendous amount of diversity when it comes to fungi or mushrooms. Fortunately, the Affordable Care Act has instituted well defined types or species of health plans that can be offered within the new insurance exchanges. Designated by metal levels, they roughly correspond to the estimated amount of coverage provided for health care expenses during the year.
- Platinum 90%
- Gold 80%
- Silver 70%
- Bronze 60%
The catastrophic plan is available only to individuals under 30 years old and doesn’t qualify for any Advance Premium Tax Credit or subsidy. The Covered California enrollment website will determine if the Individual or family is eligible for Medi-Cal and help them sign up for that program.
Variety and Form Characteristics
Covered California field guide will help you select the best fit plan.
Even within the same species of bird or mushroom you can find different varieties and forms based on the region. This is the same for the health insurance plans. A significant varietal typr will be the actual insurance carrier (Blue Cross, Blue Shield, Kaiser, etc.) for you to pick from. You’ll also find different forms of insurance offered like PPO: Preferred Physician Organization, or HMO: Health Maintenance Organization. California has 19 unique regions, just like the Sunset Western Garden Book, where the different variety of plans will be found. Not all health plans will be offered in all regions and may be restricted in some counties.
Field Guide for Covered California Health Plans
The booklet on the individual plans is a pretty good field guide for identifying the variety of health plans that will be offered in the different regions. It gives a good overview of the different health plans, where they can be found, specific characteristics like PPO or HMO and a forecast of monthly premiums for different ages and families.
How do they calculate the premium tax subsidy?
Other topics of interest such as how the Advanced Payment Tax Credits are calculated and special lower copayment options under the Silver plans are also discussed in the booklet. Covered California is also working on other initiatives to reduce the rapid rise of health care costs and improve the quality of care. The booklet is the first attempt at creating a field guide for identifying the best health insurance plans available regionally throughout California. Over time I am sure it will be updated and improved.
Covered California Booklet for Individual and Family Plans, 2014. Download PDF document
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Other helpful companion field guides or booklets:
Pediatric or Children’s Dental Plans
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Small Group SHOP
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