There has been plenty of confusion in the health insurance market throughout 2018. While President Trump has promised to overturn the “Obama Care” era of the Affordable Care Act (ACA), the reality is that most of the provisions remain in place. The only key difference is that there is no longer a tax penalty for those who aren’t covered by health insurance.
Does this mean that you don’t need to purchase California health insurance for 2019? Absolutely not. Health coverage is one of the most important purchases you will ever make, whether it’s for 2019, or any year in the future. When you have health insurance you have peace of mind and options for you and your family.
If you’re starting to think about insurance for 2019, then this guide will help you to understand what’s available and what has changed.
The Elimination of a Tax Penalty Doesn’t Mean You Should Stop Coverage for 2019
President Trump’s biggest change to the ACA was his elimination of the individual mandate rule. Up until 2018, every American was required by law to hold an insurance policy. From 2019 onwards, the individual mandate is no longer applicable. This means that you won’t be penalized by the IRS for not having health insurance.
Medical costs in the United States are some of the most expensive in the world. If you are uninsured, then the cost of unplanned medical care could leave you financially devastated. In some cases, not having insurance could lead to bankruptcy.
Regardless of tax reforms, you need health insurance so that you have coverage available in the worst-case scenario.
California Health Insurance Provides Significant Benefits, even if You Don’t Get Sick
There’s much more to health insurance than emergency care. Every health insurance policy provides coverage for emergency services. This is true even if you go outside of your provider’s network. In addition to this, there are other essential benefits that you could utilize in 2019.
The most basic medical coverage can offer:
- Seasonal vaccinations.
- Screenings for disease, based on your age.
- Psychiatric care services.
- Ambulatory services.
- Maternity care.
- Prescribed medicines.
- A pre-determined number of primary care consultations each year.
These are just some of the essential coverage options that are guaranteed by the Affordable Care Act. Of course, when you purchase a policy, you will also get coverage for specialist visits, hospitalization, and ongoing medical care for any condition or disease that you might develop during the policy. The exact amount of coverage will depend on the policy you purchase, so you will need to carefully compare your options to find something that works for you.
How the “Metal Rating” System Works
Many of the largest California health insurance providers use the “Metal Rating” system to advertise their insurance policies. From Bronze to Platinum, the type of plan usually has a direct impact on your out of pocket costs when you need medical care.
Based on an average of insurers around the United States, this is what you can expect from each type of plan:
- Bronze California health insurance typically covers up to 60% of your medical expenses. The remaining 40% will be out of pocket cost.
- Silver health insurance will have a higher premium, but 70% of your costs will be covered, while you pay the remaining 30%.
- Gold plans typically pay up to 80% of your medical costs in exchange for a higher monthly premium.
- Platinum plans are the top tier, covering up to 90% of your health costs, drastically reducing your out of pocket expenses.
In addition to these ratings, there is also Catastrophic California Health Insurance available. These plans have extremely low premiums but attract higher out of pocket costs. The coverage is typically less than 60% of your total medical bill. Catastrophic health insurance was designed for those on low incomes, or for people who rarely get ill. You need to be under 30 years of age to qualify for this type of insurance.
HMO Plans Could Become More Popular in 2019
With changes made by the current government, California health insurance premiums could rise by an average of 9% or higher in 2019. This will mean that some plans will start to drop in popularity.
PPO California Health Insurance is an option that you will have for 2019. This plan, meaning Preferred Provider Organization, allows you to receive treatment at any medical facility and receive some coverage. The insurance company will pay for more of your expenses if you visit a doctor within their network. You will shoulder most of the cost if you go outside of the network. These plans have been popular for flexibility, but they may fall out of favor due to higher premiums in 2019.
HMO California Health Insurance, otherwise known as Health Maintenance Organization, is a less flexible type of insurance where you will only receive coverage from within the HMO network. You will need to get care through a primary care physician (PCP) and will only receive coverage for specialist consultations and treatments if it is approved by the PCP. HMO insurance is highly affordable, which makes it attractive even if it is less convenient than other types.
You will also have options like POS (Point of Service Insurance), and even Multiplan Insurance (similar to an HMO). Licensed insurance professionals will help you to discover which is right for you.
Compare the Best Insurance Plans for 2019
To find the right insurance you will need to compare different policies while keeping your needs in mind. A high-premium policy could be ideal if you regularly visit doctors and specialists. A more affordable Bronze or HMO plan would be better if you are in good health and don’t expect to receive coverage during the 2019 calendar year.
Mutual Health Partners can present the best available policies based on your needs and your budget. We can make choosing insurance easy, giving you complete peace of mind from knowing that you are covered.
California health insurance for 2019 is just as important as ever. Talk to our licensed insurance professionals to find the perfect policy for you and your family.