Monday, November 15, 2010

Tips about California Individual Health Insurance, Before you Buy

We are a health insurance company that provides Medicare Advantage and Medicare Supplement Insurance in Portland, Oregon. But, we wanted to share some facts about purchasing Individual Health Insurance in California.

Are you a resident of California and looking for the right health insurance plan? If insurance benefits are not offered through your employer most likely you now find yourself doing a bit of research on California Individual Health Insurance. With so many health plans available - where do you start? What Insurance Company do you choose? If you are asking yourself these types of questions you are not alone. Use the following checklist to ensure you don't get lost on the road to applying for California Individual Health Insurance.

Identify your need

Choosing the right insurance plan starts with knowing why you need the coverage. Are you looking for catastrophic only coverage? A policy that provides more up front benefits such as office visit co-pays and prescription drug coverage? Or maybe you are starting a family and seek a policy that offers maternity benefits.

Know your budget and what benefits you get for the price

Once you have identified your need you then should take a look at your budget. Many people don't evaluate insurance benefits close enough and end up paying more for coverage than they have to. For example you don't want a policy that offers first dollar prescription co-pays when you are healthy 364 days a year. Strip the plan down a bit and go with catastrophic only coverage. Your bank account will thank you.

When choosing a catastrophic plan take a look at the out-of-pocket maximum. How much risk are you willing to take on in the case of an accident? Once you have an idea of this figure you then can compare different health insurance companies and the monthly premiums vs. out-of-pocket maximums.

If you are the type of person that sees the doctor more frequently and/or requires prescription drug coverage be aware that some of these policies have limitations. Some plans will only offer several office visit co-pays per year. Ideally you want unlimited office visits at fixed co-pay if the monthly premium is reasonable. Prescription drugs are often times assessed a brand name pharmacy deductible in which you pay full price for brand drugs until it is satisfied. If a generic prescription is available you may want to consider it because generally generic Rx are exempt from a deductible and covered right away at a fixed co-pay.

Selecting a policy with maternity benefits is similar to choosing catastrophic coverage. In the case of a normal delivery you can expect to pay up to the policy maximum. This is the general rule of thumb excluding HMO plans that will charge you per day that you are in the hospital. It goes without saying that you will want to choose the maternity plan that leaves you paying the least out-of-pocket.

Understand how effect dates work

An important part of applying for a California Individual Health Insurance plan is determining when you want the coverage to take effect. With an individual plan you have to be underwritten based upon your health history. For a person with squeaky clean health this process can go rather quickly. Approvals can happen the same week or sometimes the same day. It all depends on the insurance company once an application has been submitted. For the individual who has health conditions the underwriting process can take longer due to the insurance company having to obtain and review medical records from your doctor. On the average this can take up to a month and sometimes longer depending on how fast the company can obtain your records.

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