Kevin Knauss: Health, History, Travel, Insurance
The Silver 73 has lower cost-sharing than a Silver 70 and is unchanged for 2025. There are no medical or pharmacy deductibles. The maximum out-of-pocket is $6,100. The most significant change is that it will be available to any Covered California enrollee with income over 250 percent of the federal poverty level.
For eligible households with income over 250 percent FPL, only the Silver 73 plan will be offered, which is a better value than a Silver 70. At least for 2025, there will be no Silver 70 for qualifying households. The Silver 70 will still be offered to consumers who opt not to be considered for the Advance Premium Tax Credit subsidies based on household income.
Other plans may have an out-of-network deductible of $500 to $750+. The out-of-network deductible must be satisfied before the plan begins to share in the cost of the health care services or out-of-network services.
The goal of the program is not to have parents or legal guardians have to pay out-of-pocket for covered services and hearing aids. However, if the family has other insurance, the provider must bill that health plan first, which may require some initial costs by the family. After the private health plan has paid their share, HACCP will supplement the remaining costs.
The virtual PCP can refer to an in-person specialist. The goal for Blue Shield’s virtual PCP implementation is to reduce wait times to see a physician and reduce costs to the plan and member. Behavioral health will also be a part of the Accolade Care virtual system as well as a health coach. PPO plan members will also be able to select an Accolade Care virtual PCP.
While the network of health care providers is small with Medi-Cal programs, if you qualify for the 250% Working Disabled Program, you may be able to save quite a bit of money. To see you if you might qualify, contact your county’s social service department for Medi-Cal eligibility unit.
All of the categories of health insurance premium assistance – Individual and Family, Medicare, Employer Sponsored – can also help with out-of-pocket health care expenses. The programs will cover expenses that accrue to meeting the maximum out-of-pocket amount of the health plan. These costs include copayments, coinsurance, and deductibles, all of which add towards the maximum out-of-pocket amount.
The 2025 Medicare Part D standard benefit structure will have a $590 deductible. After the drug deductible is met the plan member goes into the initial coverage phase. During the initial coverage phase, the plan member is responsible for 25 percent of the drug costs.
My ReSound Nexia hearing aids cost thousands of dollars. They work well for me. Other people might be able to find a less expensive OTC brand on the internet to meet their hearing challenges. I review my expensive hearing aids.
Not all the below options may be available to you because some are contingent on your age, employment, or income. Those health insurance alternatives available to you are worth investigating and considering if they meet your budget or adequately address health care challenges you may be facing.
