Kevin Knauss: Health, History, Travel, Insurance
When you review stand alone Part D drug plan premiums, there will be several plans where the annual premiums are greater than your $2,400 maximum out of pocket (MOOP) amount. It makes no financial sense to pay a high premium if your drugs or generic or you expect to hit the MOOP before the end of year.
Apply for the Medicare Supplement plan first and complete underwriting if required. If approved, enroll in a standalone Part D plan and make sure the Medicare Supplement effective date matches the Part D start date.
IEHP’s mission is to “heal and inspire the human spirit.” Its stated values include placing members at the center of the organization and using creativity and courage to improve health and well-being. Those are ambitious promises, but my experience suggests that IEHP makes a genuine effort to reflect them.
The hospital network will NOT include Hoag, Huntington, Kindred, Providence, and UC Irvine. Consumers who want access to those systems may need to consider other carriers, such as Blue Shield of California, Anthem Blue Cross, or Health Net. For UC Irvine specifically, Blue Shield PPO or HMO options may warrant review.
Health Net’s 2027 individual and family plans are branded Ambetter from Health Net. Depending on the region, consumers may see standard-benefit-design HMO plans, PPO plans, or both. Plans may be available through Covered California or directly from Health Net outside the exchange.
California is also expanding state-funded premium assistance for 2027. In 2026, the state subsidy applied through 165% of the federal poverty level. For 2027, the income range extends through 200% of the federal poverty level.
A guide to off-exchange PPO and HMO options, benefits, rates, and provider networks Blue Shield of California will offer a variety of PPO and HMO individual and family plans in 2027. Californians can enroll through Covered California or purchase certain plans directly from Blue Shield outside the exchange. Most standard benefit design plans—Bronze 60, Silver […]
CMS repeatedly says it is working with health insurance companies to identify and investigate questionable enrollments. Cooperation may help reconcile enrollment and payment records, but the scope of that collaboration should be transparent. Consumers deserve to know what information is being shared, for what purpose, and under what privacy safeguards.
Covered California appears to have kept many routine copays relatively stable while shifting more potential cost to members through higher maximum out-of-pocket limits.
Some Medicare Advantage plans offer concierge-style services. For example, members may be able to call for help coordinating certain services, such as transportation to a lab or medical appointment.
