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.
California Health Insurance
Posts specifically related to California health insurance, enrollment, premiums, plans, termination, Covered California, Medi-Cal, Medicare, small groups.
Health Plan Cost Comparison Worksheet
The worksheet accounts for deductibles when they may be triggered by a health care service or prescription drug. For example, the Silver 70 medical deductible applies to hospitalization. If the deductible is met, the dollar amount is added and coinsurance for the included in the subtotals. The worksheet also accounts for tier 4 maximum amount of $250 if the drug costs more under the coinsurance of the health plan.
Older Americans Hit Hardest with High Health Insurance Rates
Without an extension of the enhanced subsidies of the Affordable Care Act, older Americans will be hit the hardest by high health insurance rates. The prime culprit is that there are no Affordable Care Act health insurance subsidies for incomes over 400 percent of the federal poverty level. This leaves older Americans potentially paying over 30 percent of their household income on health insurance premiums.
Ways to Reduce Your Health Insurance Premiums
Another powerful strategy to save on monthly health insurance premiums is the split family members into different plans. Covered California makes splitting family members into different groups very easy. From your Enrollment Dashboard select Manage Groups. Then at the bottom of the page click on Add a Group. Then drag the family members into different groups.
Can You Save Money Moving from Silver to Bronze?
Another alternative is the Bronze HDHP. While the monthly premium is essentially the same as the Bronze 60 at $231 a month, the MOOP is much lower at $7,200. When we total the annual premiums plus the MOOP, the Bronze HDHP saves this consumer $4,808 or 32.5 percent over the Silver 70 health plan.
Sutter Health Plan for Individuals & Families, 2026
All Sutter Health Plans are standard benefit designs. That means they mirror the plan structure offered by health plans offered through Covered California. They offer a Bronze 60, Silver 70, Gold 80 and Platinum HMO plans. There is no guessing if your Sutter physician or hospital is in-network with the health plan. This can be the issue for health plans that contract with Sutter.
Social Security, Taxes, and ACA Health Insurance Subsidies
The main takeaway is that the calculations for the ACA health insurance income estimates are separate from determining the tax on Social Security benefits. Specifically, all the Social Security income is included on the Covered California application as income, but only ½ is used for the combined income calculation of Social Security income taxes.
112,000 People Will Lose Health Insurance Subsidies in California under Republican Bill
Covered California has estimated that 112,000 individuals will lose the health insurance subsidy under the proposed Republican budget reconciliation bill now under consideration in Congress. Language in the bill would prevent lawfully permanent residents in close to 40 categories from receiving the Advance Premium Tax Credit subsidy to lower health insurance premiums. Republican bill to […]
Gears of Insurance: Deductible, Coinsurance, Copayments
All health, dental, and vision insurance plans will have mechanisms that have the plan member pay a certain portion of the provided services. When you know how the different parts of the member cost-sharing work overtime, it is easier to predict future costs.
2025 Changes to Covered California Health Plans
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.
