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INDIVIDUAL & FAMILY INSURANCE

What is individual health insurance?

If something unexpected happens to you – like car accident or a serious illness – hospital expenses can quickly rack up. Individual health insurance can help prevent staggering expenses if you face a medical emergency.

INSURANCE COMPANIES

  1. Anthem Blue Cross of California
  2. Blue Shield of California
  3. Chinese Community Health Plan (CCHP)
  4. Health Net
  5. Kaiser Permanente
  6. Valley Health Plan (VHP)

PLAN OPTIONS

There are four different options. Each option will determine how much a consumer will pay.

  • Bronze level: On average, the health plan pays 60% of covered health-care costs; the consumer pays 40%.
  • Silver level: On average, the health plan pays 70% of covered health-care costs; the consumer pays 30%.
  • Gold level: On average, the health plan pays 80% of covered health-care costs; the consumer pays 20%.
  • Platinum level: On average, the health plan pays 90% of covered health-care costs; the consumer pays 10%.
  • Minimum coverage plan (worst case scenario): If the consumer is under 30 and cannot afford other plans, this is another option. It covers three visits with no out-of-pocket costs and free preventative benefits. The services will cost full price until the consumer spends $7,150. At that point, the services are covered completely by the health plan.

PLAN TYPES

1. What is PPO?

PPO plans, or "Preferred Provider Organization" plans, are one of the most popular types of plans in the Individual and Family market. PPO plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.

2. What is HMO?

HMO means "Health Maintenance Organization." HMO plans offer a wide range of healthcare services through a network of providers who agree to supply services to members. With an HMO you'll likely have coverage for a broader range of preventive healthcare services than you would through another type of plan.

3. What is EPO?

EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network but cannot go outside the network for care. There are no out-of-network benefits.

4. What is HSA?

A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account which are not subject to federal income tax at the time of deposit.

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