- Health Insurances in California
- California State Health Resources
- California Health Insurance Statistics
- Types of Health Insurance in California
- Health Maintenance Organizations (HMOs)
- Health Insurance Policies
- Self-Insured Plans
- California Healthcare Marketplace
- Basics of coverage plans
- Coverage Levels
- Essential Health Benefits
- How about Dental Coverage
- About Vision Coverage
Health insurance is the most needed in everyday life. Emergencies can occur in any situation, ensuring your health is the utmost help you can do to yourself to safeguard your health and handling your financial crisis in the kind of treatment you are availing. We addictionaide majorly located in California, but our service offering is throughout the United States.
There are many types of healthcare coverage available in California, some of them are health insurance, HMOs. Medicare, Medi-Cal, but all of them were different too. Each of them follows their own set of rules and regulations, different government agencies regulate each one’s action. Now in this blog, we are specifically going to speak about the type of insurance, their statistics that are specifically available in the California region.
Health Insurances In California
The above image list the major health insurance companies that meet all state and federal requirements, as well as it also suits the additional standards that were particularly listed by the California state too. These companies represent a mix of regional and state-wise doctors, network hospitals, profit, and nonprofit plans, from a smaller company to a major level of insurers. By choosing the right kind of insurance services they offer a variety of exceptional value at affordable premiums available, you can also avail a wide range of benefits like having access to a good level of hospitals and doctors in the location where you are available in the United States.
California State Health Resources
The people who reside in California can also refer to a number of resources which are available within California:
Covered California- It is the official Healthcare Marketplace.
California Health Care Services- It provides a directory of Healthcare Services and Programs
California Major Risk Health Insurance Program- It helps to obtain the medical coverage for those who are unable to avail it on the open market. This program is developed and administered by the Managed Risk Medical Board, which provides health insurance for all the residents of California.
California Health Insurance Statistics:
A few statistics that are particularly stating about the California insurance schemes and the ratio of people who avails the insurance plan and how many people have not enrolled in that yet and also the average level of contribution & package.
- The total population of California is about 39,188,300.
- In that about 8% of people were uninsured.
- About 21,414,031people in California have enrolled themselves in HMO.
- An employer contribution of about $1,146 annual(avg) premium is collected for a sponsored plan.
- Avg CA hospital cost per inpatient day (before insurance)
Types Of Health Insurance In California
Here in this part of the blog, we are going to discuss the types of insurances that are available in California.
Health Maintenance Organizations (HMOs)
They are available either as an individual plan or a group plan, the state government and the law of California have some regulations for this kind of healthcare coverage. When a patient has to be benefitted by this kind of insurance, they should have a primary care doctor who provides basic care and refer them to a specialist if they have to be treated or consulted more specifically.
It provides a strict rule that you should only avail treatment services at the approved network hospitals otherwise you can’t claim anything or pay for your service unless or otherwise if it is an emergency condition. If a person needs to receive this kind of coverage, he or she must be living in the area where these HMO services are available or otherwise it is entitled to the need for emergency care.
Health Insurance Policies
Health insurance policies cover both the medical care and hospitalization for the patients who avail this insurance type. Mostly all the providers have a list of specific conditions and the list of requirements that which can policy agrees and which one doesn’t rely on it according to the contract signed. As of the HMO’s, these health insurance policies were available for both the individuals/families/groups.
Group policies were majorly purchased by employers for their staff members. In some cases, companies provide opportunities for their employees to add their family members in the insurance plans. Some employers pay the total amount of the scheme, some may pay a partial amount of the monthly premium.
Even if anybody wishes to purchase their health plans outside their workplace, they can but these kinds of plans will comply with the rules and regulations that are imposed by the Department of Insurance, California.
Self-insured plans were offered by larger employers, this means a company which has a particular budget to cover the healthcare of their employees. Most of these kinds of companies have a contract with many insurance companies, in order to manage the health benefits, they are available to their employees. In this kind of insurance plan that employees may not be served with the same kind of benefits or protection plans that are covered by other insurance types since it does not come under the rules and regulations by CDI. This kind of insurance service is monitored by the Federal Employee Retirement Income Security Act of 1974 (controlled by the EBSA).
Medi-cal is a type of insurance that is available in the California region and it is a version of the Medicaid program. This program helps people who have lower family incomes or covers single adults. Managed Care Organizations also provides plans that are free but it is available for only those who meet their requirements.
California Healthcare Marketplace
Insurance products that can be purchased by small businesses, families or individuals are offered by private providers that are mainly covered by the California platform. It is a useful platform that was created as an integral part of the Affordable Care Act. It specifies a list of regulations that the marketplace should operate by, which includes the services that cover mental health and substance abuse.
Basics of coverage plans
As the insurance market avails many insurance plans, it is sometimes overwhelming to select the best thing which suits us more. Here we have listed a few points that can clarify you about the basics you need to stick with when you need to choose the insurance plan.
Now the insurance plans forward to the individuals or employees have four levels of coverage plans, you choose the one which fits for you: Gold, Platinum, Silver, Bronze. In addition to these plans, we have another one more which is a minimum coverage plan that is available to the people who are younger than 30 years, they are requested to provide the appropriate financial or eligibility certificate to avail of this plan.
Essential Health Benefits:
Whatever kind of insurance plan you choose for yourself or offered by a company has a set of packages of services and items that comes under that plan, these are commonly known as the Essential Health Benefits. These kinds of benefits fit into 10 categories which include services like emergency care, prescription drugs, mental health care and etc.
How About Dental Coverage
Through optional dental family plans now the California state is offering from dental coverage for adults. In addition to that as an exchange or supplementary, it offers pediatric dental care for the children which is included in all the health plans purchased. So try to choose the plans according to your requirement, you can have multiple options to avail the services from, but know what your state insurance policies too.
About Vision Coverage
Insurance plans that are covered in California, has a new pathway towards the quality of vision care. The benefits of vision care for the children were included in the health insurance plans that are purchased through the exchange programs. Normally vision care for adults was not available in the health plans of covered California. But it works with some of the vision insurance companies to offer the vision coverage directly to the consumers.
Having insurance is a must since it can help you out in an emergency situation, where it plays an eminent role in availing affordable treatment or if you are running out with a financial crisis. In the United States, each state has its own insurance policies and schemes, while choosing a plan you should be knowing some important points about what the plan it is, what kind of treatments it will be covering and in which area or network hospitals we can avail this insurance types. In most of the insurance plans, we can claim it if you have admitted to a non-network hospital in the emergency cases.
Even if you have an average monthly income or you are not financially very strong, you too have a kind of insurance plan to support your Mental Health treatment/ prevention of mental illness or physical injuries. So there is nothing that can stop you from getting a good family health insurance for your family since you can’t judge the future emergencies. So be wise about choosing things that help your treatment………