California Health Insurance
by Steve Valentino
Health insurance is a kind of insurance that helps to keep the costs of health care low. It is exclusively meant for medical reasons. Health insurance can be either individual insurance or group insurance.
There are several kinds of health insurance plans available today, with attractive options. Choosing the right plan according to individual requirements is very important. There are many costs to be taken into consideration while choosing a health insurance plan. The most important thing is the basic premium that is to be paid. This can be a monthly payment made by either you or your employer. There would be other payments also that very according to the plan. The total cost the plan is to be taken into consideration.
California health insurance plans may be categorized as indemnity (fee for service plans) or managed care plans. There are many differences between these two kinds of plans: choice of doctors, the mode of bill payment and the other out-of-pocket costs for the services covered. Indemnity insurance plans provide a greater choice of hospital and doctors. In indemnity plans, the share of the cost of the services is paid only after receiving the bill. Managed care plans, on the other hand have lesser choice of hospitals and doctors, as well as lower out-of-pocket costs. There are again three kinds of managed care plans: Preferred Provider Organization (PPO), Health Maintenance Organization (HMO) and Point of Service Plan (POS). Other kinds of California health insurance plans are Medicare, Medicaid etc.
California health insurance has another feature called Cal-COBRA, which is a California Law relating to extension of current group insurance when there is a qualifying event like termination of employment or reduction of hours from part-time to full-time. The extension period is 36 months. For Cal-CORBA to be applicable, the group policy must be in force with 2-19 employees covered on a minimum of 50% of the working days during the preceding calendar year or the preceding calendar quarter. Cal-COBRA is applicable to only indemnity policies, PPOs, and HMOs. It does not apply to individual health insurance policies and self-insured plans. It however, covers church plans. Cal-COBRA is regulated by the CDI and the DMHC, depending on the type of coverage.
California offers special insurance policies for those small employers (2-50 employees) as well as for those who do not qualify for insurance because of income restrictions or preexisting conditions. People who are not eligible for insurance under COBRA, Cal-COBRA or Health Insurance Portability and Accountability Act (HIPAA) can purchase insurance under another special provision called Major Risk Medical Insurance Program (MRMIP). Other California health insurance policies are: Healthy Families Program (HFP), Access for Infants and Mothers Program (AIM), Pacific Health Advantage (PacAdvantage), and other Supplemental Health Insurance Policies.
The main aspects to be considered while choosing a California health insurance plan are: how the plan handles medical care like: physical examinations and health screenings, care by specialists, hospitalization and emergency care, vision care, prescription drugs, and dental services; what is the care and counseling for mental health; what are the eservices for drug and alcohol abuse; is there ongoing care for chronic and long-term diseases; does it cover physical therapy and rehabilitative care; does it cover nursing home, home health and hospice care; does it cover alternative medical care like acupuncture; does it cover experimental treatments and therapies etc. Other things to be considered are the cost of services, receipts and filing claims. While choosing a plan, also look for the other services offered, the choice of doctors, location, deductibles and other costs and so on.
There are many health insurance companies in California. Information about these companies and their insurance plans can be obtained over the Internet. This will allow you to compare various alternatives and also know about the latest options.
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