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4 Tips on Choosing Good Health Insurance in California

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4 Tips on Choosing Good Health Insurance in California

There are a lot of health insurance options out there, but with so many different kinds of coverage, insurance gimmicks and jargon from insurance agents that sounds like a terms from a different planet, it is hard to know whether you’re buying health insurance to live by, or die from! To help you sort through the maze here are some helpful tips to let you know what to expect and what you are getting when you sign up.

Gr andfather Exemptions

Yes! This is real! This occurs when you employer makes no substantial changes to your insurance plan, and, if you are wondering why, it is because this type of insurance is not required to conform to certain required provisions in health reforms laws. This means there will be no copay for preventive services like immunizations, blood pressure testing or smoking cessation programs. It would be a good idea to check with the plan (before the excitement of job acceptance takes over) to see if it is gr andfathered and what benefits it does provide.

Make Plan Adjustments

Things never stagnate in an upbeat area like Brentwood Hills! The coverage you paid for and the benefits you received say, five years ago, will need a definite upgrade! An example of this is adding an ‘adult child’ back into your insurance for coverage. Plans are suited to cover children up to the age of 26; but old-fashioned – this refers to gr andfathered – plans will exclude the ‘child’ if they are insured through an employer. A good bonus is that children under the age of 18 can no longer be turned down for insurance because of pre-existing ailments like asthma or cancer.

Have a Separate Account for Healthcare Expenses

You can save a big amount on premiums in Malibu if you set up a health care savings account for health financing. When set up correctly a small fee is deducted from your pretax income to finance health savings or flexible spending accounts; this makes for a big help. Both of these have pros and cons however. Health savings accounts must be paired with a high-deductible plan while a flexible spending account can go with all plan types, but you will lose any leftover contributions that go unused by the end of the year. This means you won’t be able to pay for over the counter medications like Tylenol or Prilosec using HSA or FSA dollars without a written note from your doctor. Save yourself the head ache (you can’t afford the Tylenol anyway) and decide which plan best suits you beforeh and.

‘Marry’ Your Spouse’s coverage to Yours!

If you spouse or children come under your plan, make sure your boss still gives the same funds toward premiums for family plans. Some companies have made the decision to pay for each dependent separately, in which case ‘Junior’ will be an insurance liability rather than an asset. More and more employers are also adding surcharges for spouses whose employers pay for insurance. In this case, you may find it is better to ‘divorce’ your spouse from the plan – but not from you!

Healthcare Reform in California

Lawmakers will need to move quickly to clear the way for Californians’ enrollment in a new state-run insurance market next fall in the run-up to the Affordable Care Act.

Lots changes happening, lots of changes every day.

When state lawmakers are sworn in Monday for the new legislative session, they will have little time to enjoy the pomp and circumstance.

Facing a federal deadline, the Legislature must move quickly to pass measures to implement President Obama’s healthcare law and revamp the state’s insurance market. New legislation will help extend coverage to millions of uninsured Californians and solidify the state’s reputation as a key laboratory for the federal law.

Legislative leaders have said they also want to overhaul environmental regulations, curb soaring tuition at public colleges, and tweak the state’s tax structure and ballot-initiative system.

But healthcare remains one of the largest and most immediate challenges.  Read on, this is important stuff.

The federal Affordable Care Act takes effect in January 2014, when most Americans face the requirement to buy health insurance or pay a penalty. State lawmakers must pass a series of rules to clear the way for enrollment in a new state-run insurance market next fall, including a requirement for insurers to cover consumers who have preexisting medical conditions and limits on how much they can charge based on age.

Gov. Jerry Brown is expected to call a special session of the Legislature next month — concurrent with the regular session — so healthcare bills that he signs can take effect within 90 days rather than the next year.

“It’s a very, very big undertaking to make the promise of the Affordable Care Act a reality,” said state Health and Human Services Secretary Diana Dooley. “We are working as hard and as fast as we can in a very complex area with a lot of conflicting information.”

As an early adopter of the Affordable Care Act, California has already laid much of the groundwork.

It was the first state to establish an insurance exchange after Congress passed the legislation in 2010. More than 30 other states have since sought federal help in enacting their own. Millions of Californians will be able to purchase coverage, with federal subsidies earmarked for families earning about $92,000 or less annually.

One of the most significant proposals will be an expansion of Medi-Cal, the state’s health insurance program for the poor. About 2 million low-income Californians would be newly eligible under the expansion, with the federal government subsidizing costs for the first three years. The state would then shoulder a portion of the bill.

According to a Kaiser Family Foundation study, the expansion could cost the state $6.3 billion over a decade, meaning a 1.7% increase in the amount California spends on Medi-Cal.

California got a head start on the effort by signing up more than 550,000 low-income people in a temporary program. They are expected to automatically move into Medi-Cal in 2014.

Lawmakers will also consider legislation that would create a health plan for people who cannot afford insurance on the open market but make too much money to qualify for Medi-Cal. The option, known as the Basic Health Plan, would provide coverage for individuals with incomes between 133% and 200% of the federal poverty level, or between $15,000 and $21,800 a year.

State Sen. Ed Hern andez (D-West Covina), chairman of the Senate Health Committee and author of the proposal, said the plan was needed to help California’s working poor. “I don’t think they should be choosing between putting food on the table and buying health insurance,” he said.

Insurers urged lawmakers to resist requirements that could make policies offered through the exchange unaffordable.

“We think the Affordable Care Act does much to get millions of people coverage, but new insurance taxes, costly benefit requirements and age pricing restrictions all have the potential of driving up costs,” said Nicole Evans, a spokeswoman for the California Assn. of Health Plans.

Healthcare advocates said it was critical for the Legislature to promote policies that would ensure a mix of healthy and sick policyholders to keep premiums affordable.

“It should be a goal of the state to have millions of people enrolled on Day 1,” said Anthony Wright, executive director of the consumer group Health Access California, “to bring in those federal dollars and make healthcare cheaper for everybody.”

 

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