What is the Difference Between Health Insurance Companies in California?
January 23rd, 2010 | 
Author: Whether you already know it or not California has a lot of options for health insurance. There are companies that we all heard of and there are some companies that we never heard of. With all the Health Insurance Companies out there you might be wondering what the differences are and which one is right for you.
First in state of California the health insurance companies you should be looking at are; Aetna, Assurant, Blue Cross, Blue Shield, HealthNet, Kaiser, Nationwide, PacifiCare, Celtic and new company that is going to be available in state of California is Golden Rule. These are the largest carriers that are available in the State of California. If you are looking at any other company that was not mentioned previously, use caution. With all the health insurance premiums going up there are companies that prey on people with low premiums and coverage that does not cover anything. They are just out there to make a quick buck buy collection as much premiums as they can before you cancel your coverage. Stay away from companies that you never heard of, not matter what they tell you. If you hear something like, “affordable health insurance for self-employed”, run.
Second what you have to understand that the actual cost of insurance no matter what company you go with is about the same. So how do insurance companies have so many different plans with different premiums? If it is a large insurance company and the company ran efficiently that is how you get great premium with great coverage. What creates variety of prices for coverage is the creative aspect of the insurance company designing their plans. The way they do it is by deductibles, co-pays, co-insurance, drug coverage deductibles, whether the plan covers brand name drugs or generic drugs only, maternity coverage, maximum out of pocket, deductible and co-pays for all kind of different services.
The name we all know is Blue Cross Blue Shield. Blue Cross has been around since the recession of 1929, and it used to cost only 1 cent a day. The times have changes since then, but the Blue Cross name is still around. Blue Cross has been over the years the most stable largest health insurance provider in the United States. Their strategy is to keep rates stable and have stable rate increases. While most other plans might lower their rates to get more people on their coverage and then keep increasing their rates. There fore as some plans might be more attractive in premiums at the moment over time eventually they have to catch up with the actual market health insurance cost. Sometime the company has to charge people more for health insurance in the future so they can give more affordable rates today. Blue Cross will give the one of the largest varieties of plans to choose from and you can always downgrade a plan without going through underwriting is the monthly premiums because to expensive.
The most competitive health insurance coverage you will be able to get in California today is through Aetna and once Golden Rule plans come out by United Health Care then Golden Rule plans are going to be the most completive plan. Every time most of the large insurance companies enter a new state with a new plan they make that plan more competitive just to capture the percentage of that market eventually the company will have to raise their rates to the market level. Aetna plans in California are the most competitive. This is where you can get the most coverage for your money. Keep in mind that the Aetna Individual plans in the state of California do not cover Maternity.
Assurant Health Plans is provided through Fortis Insurance Company witch is the 26th largest company in the world and Fortis Insurance Company has been around since 1892. Assurant Health Plans are the most widely accepted and flexible plans that are available on the market today. Assurant Health Plans utilizes dozens of provider networks Nationwide to give you the worlds largest selections of doctors in United States and worldwide. Assurant Health Plans are the only plans that will cover you world wide as they will cover you in the United States. There is a big difference when insurance company says that you are covered for emergencies worldwide. Insurance company can make a final decision on whether that was true emergency or not. Assurant Health Plans have no such restrictions. Assurant is the only company that will allow you to move to different state without going through underwriting process all over again. That meant that with most companies even if it is a same company if you move from one state to another you have to cancel you policy in the current state and re-apply in the state that you are moving to. The down side with Assurant in some states is that they are not the most competitive and harder to get approved for. If you considering HSA plan, Assurant Health is the best options available to individuals and families.
Blue Shield of California is great coverage especially if it is young family looking for a plan with maternity coverage and for a family where one of the adults on the plans is significantly younger than the other. Blue Shield bases their monthly premiums on the youngest primary policy holder. This can be any adult in the family. Blue Shield plans have low maximum out of pocket and wide acceptance with doctors. A lot of doctors in state of California prefer Blue Shield plans because Blue Shield reimburses them faster than most other insurance companies. Keep in mind that in some states Blue Cross and Blue Shield are the same company in state of California they are two different insurance companies competing for your business.
HealthNet of California is the insurance company available in western states. HealthNet family plans are affordable, have some of the lowest maximum out of pocket and designed for healthy individuals and families. The new line of plans form HealthNet are their popular no deductible PPO plans. Which are some of the worst plans for families. No deductible plans are not designed for families since they have extremely high maximum out of pocket witch might be a great fit for single healthy individuals. HealthNet of California also offers some of the best HMO plans available on the market. Health Net’s simple design and affordable plans are perfect match for healthy families. The way their family plans work is that once you meet your deductible HealthNet will pay 100% for all of your medical expenses after that. The down side is that their family plans do not cover regular sick doctor visits. The money that you are going to save monthly is going to be way worth no having doctor visits covered until the deductible is met. All you will get is negotiated rates that HealthNet has with doctors and hospitals. Your doctor office visits are going to cost you anywhere from $65 to $65 per visit.
Nationwide Health Plans have some of the great unique options that other plans just don’t offer. The only way you can get Nationwide health plans is by being a member of California Farm Bureau. Anyone can become a member of California Farm Bureau also know as Farmers Association. Because it is a group plans it has some options available that most individual plans do not have. You still have to qualify medically to get health insurance through Nationwide. Nationwide offers some of the most comprehensive health plans available on the market today. Nationwide health plans offer low maximum out of pocket. Some plans that they offer work similar to the way HealthNet’s plans work. Once you meet your deductible Nationwide covers everything at 100% and Nationwide plans cover doctor visit before you meet your deductible and Nationwide is the only health insurance company that has no prescription drug deductible on most of their plans. If you are looking for the most competitive HSA plans, Nationwide will be your choice.
PacifiCare is company that has been available to Californians for a long time until recently they were bought by United Health Care. PacificaCare will be replaced by Golden Rule health plans. If you have PacifiCare you might want to find out if you will have to re-qualify medically for new health insurance once they take the company of the market. Golden Rule owned by United Health Care witch known as the quality company and recommended everywhere. If you are considering PacifiCare I would wait for Golden Rule or get something else. For more great resource on Health Insurance visit www.GuideToHealthInsurance.org
Question about health insuranceHealth insurance?
I have health insurance with my employer and it only covers 80% of the expenses. If I go to the doctor will they bill me for the 20% I have to pay out of pocket, or will I have to pay right then.
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The Republicans are in trouble now. People are getting slaughtered and they don’t even have a healthcare bill to go on TV with against the Big-Bad-Bama. Their strategy is to cover a handful of people – let the rest burn & complain about the deficit. Great Plan!
1) Most employer provided health insurance is deducted "pre-tax" so there is no deduction on the tax return.
2) Your parents must be your dependents (or would have been your dependents except for the gross income test) for you to take a deduction anyway. So, unless you are supporting them: No.
The 20% does NOT automatically get deducted from the paycheck!!!!
You will probably have a co-pay that is due at the time of service. You will then be billed for the 20% not covered by your health insurance.
There are certain government programs and nonprofit organizations that can help.
One such program is at:
http://www.nlm.nih.gov/medlineplus/financialassistance.html
For a list of federally funded health centers go to:
http://findahealthcenter.hrsa.gov/
You can find many more government and low cost resources for all kinds of health concerns at
http://www.simplyinsurancequotes.com/links.php?id=bghott12bq09
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Here you can get quotes for private insurance:
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more at:
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You've asked a very broad question. There is no simple answer.
In truth, health insurance works a little differently in each state.
To answer your specific questions:
1) No, health insurance is not compulsory for everyone. If you're lucky, you are able to join a group policy at work. (If you're really lucky, it's a good policy and the employer pays at least half of it.) Some states have recently made it compulsory, but that's such a recent change that there's no clear cut answer yet for how that's going to work.
2) What happens if someone can't afford it is… they don't get it, usually. Except if your income puts you below the "poverty level", in which case you qualify for Medicaid. (In some states there are programs that typically provide assistance with insuring children, though they are few and far between for covering adults.)
3) Health insurance rarely covers all the bills when you have a procedure done. Most plans cover 50-80% after you meet your deductible. The deductible amounts vary widely (but the trend is that the deductibles are getting higher and higher to keep the premiums down.) If you're really, REALLY lucky, you don't have a deductible (which is only an option on group plans), and you may only have to pay 10% of covered charges. (These plans are few and far between. As in, you might have them if you're in Congress.)
4) Yes, the patient has some say over procedures. However, if the patient opts for an "experimental" procedure, or one that isn't deemed "medically necessary", then health insurance may refuse to cover any charges at all.
In the end, as with most things, the middle class takes the brunt of these costs. This has become such a problem that more than 50% of all bankruptcies are as a result of medical bills (and of those, more than 75% had health insurance.)
** Edited to add:
It's not ALL about the money when a procedure is involved. If it is, the state keeps track of complaints filed on behalf of consumers with "managed care" (ie. any type of network arrangement including Preferred Provider Organizations, Health Maintenance Organizations, and Point of Service organizations — also known as PPO, HMO, and POS) and may very well revoke a company's charter to do business in the state should the company be turning down too many legitimate claims.
However, insurance companies are sticklers for following the "standard" for medical care. This is what makes it difficult to answer your question. Because they should not deny anything that's considered standard for care in the given circumstances (should not and will not being two completely different things, of course.) And there may be several options that would be considered "standard." If the patient wants treatment that isn't yet considered "standard", they would balk. Period.
The purpose of any type of insurance is to protect against catastrophic loss. Using health insurance as an example, most everyday medical expenses are not very expensive (a physical exam averages $150.00+/-), but if you are admitted to the hospital for an emergency your medical bills would be in the tens of thousands of dollars at a minimum. If you do not have insurance you "self-insure" againts that potential catastrophic loss. Without insurance, the average person would face financial ruin if faced with a major loss.
No.
The insurance through your husband's employer does not meet the test of having been established through the S-corp.
i htought the main reason of living in a society was to help each other out, am i wrong?
Well, if she's 40 and perfectly healthy, it's going to cost her about $500 a month to have a low/no deductible plan that covers checkups.
You BUY it on a month to month basis. If you want low monthly payments, you have to cut the coverage – like take a $10,000 deductible. Or higher. That would cut payments down to maybe $200 a month or less.
The older she is, the less healthy she is, the more it costs.
Your best bet, is to find a local, independent agent, who can help you balance cost with coverage.
most insurance will cover the costs you mention if the doctor thinks it is medically necessary.