How to buy California Health Insurance

There are a couple things you should ask yourself before you buy health insurance. What do you want and what do you actually need?

Everyone wants a low deductible, office visit co-pays and good prescription coverage but what a person may need can be far different. Health insurance can get extremely expensive depending if you choose to elect a low deductible health plan with first dollar benefits. Such a plan would serve very well the individual who visits a doctor frequently, although the plan would most certainly come with a hefty price tag. On the other hand, if you are completely healthy and see a doctor but once year, then having a lot of first dollar benefits and a low deductible will leave you paying high premiums for coverage that you never use.

Before you buy a health insurance policy you should take these areas into account.

Are you in good health? (This will determine what is available to you and have a bearing on your monthly premium if approved for a health plan)

How many times do you go to a doctor in a given year?

How much money are you comfortable with in paying a monthly premium?

Do you want strong catastrophic protection for a serious emergency? (a low out-of-pocket maximum)

How important are your first dollar co-pays for doctor’s office visits? (offered before you have to satisfy the deductible)

Is strong prescription drug coverage important to you? (low co-pays for generic, brand and formulary drugs)

When choosing individual or family health insurance, being in good health is critical. Health Insurance carriers are still for-profit businesses (until president Obama says otherwise) and will decline your application if they feel you are a potential risk. This fact alone is why you should consider buying health insurance why you are healthy. Health insurance carriers can not terminate your plan if you come down with a serious illness or have an accident. They also have the right to rate your monthly premium higher than the original rate if you have pre existing conditions.

How many times you see a doctor in a given year will help you (or your insurance agent) determine what type of a plan you need. If you see a doctor but once a year you may benefit from a high deductible health plan (catastrophic plan) that has the availability of one physical exam. In this case you will pay a lower monthly premium your health plan will better fit your lifestyle (until you need better coverage someday). If you see a doctor several times a year then a plan with office visit co-pays before deductible will better suit you.

The old saying “you get what you pay for” rings true when it pertains to health insurance. I am a healthy 27 year old male and what I make a year would not be enough to cover the high premiums I would pay for a low deductible health plan. Let me show you…

The following quotes are with Blue Shield California and are based on a healthy 27 year old male in Sonoma county California.

Shield Spectrum 500 $310
Shield Spectrum 750 $219
Shield Spectrum 1500 $193
Shield Spectrum 2000 $113
Shield Spectrum 5000 $63

The winner in this case would be the PPO Savings Plan 4000 at $54. I would have a physical offered once a year for a $35 co-pay and my out-of-pocket maximum is only $4000 a year. This means after I satisfy the deductible that everything is covered at 100%. Considering I would only need to use it in an emergency, this would be the perfect plan for me.

In the event that you require strong prescription drug coverage you want to be aware that many plans out there will strip the Rx benefits in order to make the premiums more affordable. Many companies will offer generic only prescriptions while some will put “caps” on the yearly maximum pay out. In the event that you have a catastrophic emergency and require expensive brand name drugs you want to make sure your plan offers both brand and generic Rx with no cap on the maximums.

As always, if you have any questions please contact me or J.C. Lewis Insurance Services ; our services are at no cost to you!