But if you don’t have an account, are trying to help a family member or friend, or are just checking to see if you current mental health provider might be covered in a new health plan, you will have to swim in the sea of confusion for finding the doctor or counselor. Some of the health plans have great online directories and others really suck. Here is an overview of what I learned.
The Department of Managed Health Care (DMHC), who regulates most of the individual and family plans offered through Covered California, has developed a website to allow consumers to compare health insurance companies. The Health Plan Dashboard website does not assign any performance review ratings. But it does give consumers a high level view of some of the data collect on the health plans such as enrollment, complaints, and enforcement actions for medical, dental, and vision plans.
The California individual and family plan market place will be changing quite a bit in 2017. Next to confirming if your favorite doctors are covered by the new health plans, many consumers want to make sure their chosen hospital is in-network as well. From information provided by Covered California and the health plans, I have put together a table of California hospitals by region and the health plans they accept.
On October 29th, 2014, Chinese Community Health Plan (CCHP) was notified that they were being put on immediate imposition of intermediate sanctions from the Centers for Medicare & Medicaid Services (CMS). The Medicare sanction was triggered by what the CMS auditors concluded were severe violations in the Chinese Community Health Plan Medicare Advantage (MA-PD) plans offered in […]
How health insurance companies and health plans determine premium rate increases is a little bit of a mystery. Covered California didn’t add to the consumer’s understanding of this process when they released their 2015 health insurance booklet. The plan rates booklet is mostly marketing material and fails to provide specific rates by region, carrier, and […]
Thanks to the Affordable Care Act all individual and family plans now include coverage for maternity care. These new health services, many of which are provided at no cost to the patient, also extend to the new born. Prominent in many private health plans is coverage for routine infant circumcision.
Covered California released their small business health option plans (SHOP) for small employers and they might prove competitive for some companies with less than 50 employees. There will absolutely be small businesses that will not participate because they don’t want to support any government bureaucracy, even if it is to their benefit.
Covered California has been assuring health insurance agents that they will be an important part of the effort to enroll millions of residents in affordable health insurance. Unfortunately, many of the health plans they have selected for the California market place are giving insurance agents the cold shoulder.
Covered California will be offering 13 different health insurance plans to individuals and families. Some of the plans will be offered through large commercial insurance companies and other from smaller regional organizations. Ten of the thirteen plans have some form of easily accessible report card on their services from either a state agency or accreditation organization.
It’s hard to compare the plans side by side because of the diversity populations they serve and lack of data on some of the health insurance companies. Much of the information about the different health plans and companies is spread out over several different agencies, reports and websites.