Kevin Knauss: Health, History, Travel, Insurance
Posts related to health insurance for individuals, families, small groups, enrollment, eligibility in California, plans, coverage, benefits.
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.
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.
Address Change SEP: If you must move because of your illness and your existing health plan is not offered, then you could change health plan and metal tier.
My customer service ratings are subjective based on my interaction with the carriers and reports from clients. What you will notice is that potentially those smaller regional carriers are going to have better than average customer service. Why? They’re smaller. Generally, the customer service staff is in California. It’s not offshored, so you’re usually talking to an individual when you can get through and actually talk to someone.
Aside from the covered benefits of ACA health plans offered in California, the premiums reflect cost of delivering health care services. In other words, the premiums reflect the cost of paying claims to a variety of providers from therapists to hospitals.
When I view an AI generated health insurance plan comparison and analysis, I’m very impressed. I can see how AI will fill the analysis and comparison of health plans for many consumers.
However, there can be no mistake that AI is becoming more sophisticated in providing financial analysis for health insurance. There is a large population of people for which the AI analysis is good enough to base a health insurance decision upon. This makes health insurance agents obsolete in many situations.
Unfortunately, it can be confusing to know when the deductible applies and what coinsurance means. Coinsurance is simply a percentage of the cost of the health care service that the health plan member is responsible for.
