Kevin Knauss: Health, History, Travel, Insurance
Posts specifically related to California health insurance, enrollment, premiums, plans, termination, Covered California, Medi-Cal, Medicare, small groups.
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.
There is no abortion tourism, a term Serevino uses to trivialize the critical health care decision by a woman. Some states have increased abortion procedures, not because women want to visit Disneyland, but because their home state has banned the procedure. It also appears that Serevino is advocating for the expansion of the surveillance state. He wants as much data on women and their health care decisions as possible. It is kind of creepy.
Jericho Share, a purported Health Care Sharing Ministry, fined and ordered to cease operations in California.
The paths to health insurance in California: Medi-Cal, IFP, Employer, Medicare, overview.
Platinum plans can save money because they have health care and prescription drug costs half of the Gold and Silver plans. The Platinum plan only makes sense if you can reliably predict the health care and prescription drug utilization in the next year. For everyone else, without that crystal ball, a Silver or Bronze plan work better at containing health care costs.
Silver 73, 87, and 94 health plans, available through Covered California based on household income, have no medical deductible. That does not mean you escape any patient responsibility for health care services subject to coinsurance. With the enhanced Silver plans, you go straight into the coinsurance percentage for inpatient hospitalization and skilled nursing facility stays because there is no medical deductible.
The cost of major surgeries or cancer treatment can easily top out at $100,000 or more. The health insurance with a maximum out-of-pocket amount limits your liability so you do not have to liquidate your assets to pay the doctor and hospital bills. Health insurance protects your assets.
There are non-standard benefit design health plans offered by carriers off-exchange. You cannot enroll in a non-standard benefit design plan through Covered California. The off-exchange non-standard benefit design plans are usually in the Bronze and Silver metal tier categories. There are more High Deductible Health Plans (HDHP) that are health savings account compatible offered off-exchange.
Effective January 1, 2023, a new California law expands the definition of “dependent” for the purposes of enrollment in a Qualified Health Plan (QHP), to include a parent or stepparent of a qualified consumer. Rules for this benefit include that a dependent parent or stepparent must:
The one wildcard with outpatient services is the coinsurance. Coinsurance is a percentage of the invoiced services that the health plan member is responsible for. For outpatient procedures, the coinsurance is not subject to the medical deductible for Silver plans. However, you may find yourself getting billed for coinsurance when you thought the health service had just a set copayment. For example, imaging with the injection of a dye to enhance image contrast. The machine imaging scan will have a set copayment, but the injection of the dye is considered an outpatient procedure subject to coinsurance.
