The new targeted California health insurance market offers a wide range of affordable health insurance plans to choose from. Whether you are self-employed or looking for coverage beyond what your employer currently offers, there are plans that are likely to meet your needs.Federal regulations require certain eligibility requirements. To meet my needs, I need medical insurance operating under the Affordable Care Act (ACA). In California, these requirements include timely access to healthcare providers and geographic access criteria.
Here’s a general guide to personal health insurance you can refer to when choosing a plan. And don’t forget these important 2016 public registration dates.
provider network
When choosing a health insurance plan, it’s important to check the plan’s provider network of doctors, hospitals, nurses, therapists, and other health care providers. It is equally important to understand what is not covered. Understanding your plan’s provider network can help you save money, receive better care, avoid unexpected charges and costs, and be satisfied with the care you receive.
Off-network care
Although not limited to on-network providers, if you decide to use an out-of-network provider, your health insurance coverage will be less and your out-of-pocket costs will be higher, except in emergencies . Provider does not exist in network
Generally, when a provider leaves the network, they will need to find a new doctor within the network, and most plans will help with this. Health insurance companies’ continuation policies typically allow patients to continue treatment with non-network doctors for a period of time at a lower out-of-pocket rate.
Cost sharing requirements
Each plan has different cost sharing requirements. Total cost burden is usually a combination of premiums paid and other co-payments, co-insurance, or financially responsible deductibles.
How to find a doctor
In most cases, the plan you choose includes a list of doctors who accept insurance. The California Medical Board offers some great tips for choosing a doctor.
Ask friends, family, or colleagues about their favorite doctors.
Ask your district medical board or association for the names of doctors in your area.
Once you have a few names, call and ask if the doctor is accepting new patients and if they are accepting your insurance plan.
Check with the medical board to make sure the doctor has a current California license.
Please meet with your doctor and review your physical exam to determine if this is the right doctor for you and your family.