There are multiple types of health insurance coverage in California which follow their own set of requirements and rules. Healthcare coverage for an individual is not currently required in the state but always recommended. The following is a list of coverage options for citizens of California.
A health insurance policy provides coverage when you require medical care or are visiting a hospital. Your policy explains what ailments are and are not covered. Consumers have the option of purchasing policies as a group or individual/family.
A group policy is purchased through your employer or another type of association. The insurance company issues the policy based on the name of the group and provides Certificates of Coverage to each employee. In many instances, you can add family members or other dependents to the policy which you will generally pay for some of the monthly premium.
An individual or family policy is a type of insurance you purchase outside of an employer. This type of policy is issued to the applicant and their family. Once you have been granted a policy, you can add family members and other dependents, in most cases.
All forms of insurance must abide by the laws of that state. In California, all insurance policies are regulated by the California Department of Insurance.
There are numerous types of health insurance coverage options, including EPO’s, HMO’s, and PPO’s that have different requirements.
An EPO requires you to use providers within the EPO network. In general, you are not required to use a primary care doctor and do not need referrals to see in-network specialists. However, EPOs often have limits on the doctors and hospitals you use and will not cover out-of-network services.
An HMO requires you to use an in-network doctor. You must have a primary care doctor who may be an employee of that HMO. You must also live in the area that an HMO services.
A PPO offers a network of preferred providers in which you will pay less to visit. You can use an out-of-network provider, but you will pay more. It is essential to ask what facilities and doctors you can use when shopping for insurance.
For more information on California health insurance, contact the Independent Insurance Center today! Our professionals at the Independent Insurance Center are standing by to help you find the best coverage options!
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