For Health Insurance, You’ve Got Options
Call today for a quote and personal service: Toll Free (855) 535-0670
For all Medicare inquiries, please dial 714-705-4051
Big Names. Bigger Selection.
One of the nation’s leading providers of health, dental, group life, disability and long-term care benefits.
Medicare beneficiaries enjoy exclusive benefits offered to Alignment Healthcare members and experience a new level of care that puts you first.
Anthem Blue Cross of California offers affordable individual and family plans, employee benefit plans, Medicare, Medicaid,, dental, and vision insurance
With 2.6 million members, Blue Shield is one of the leading health plans in California.
California’s only small group private exchange. Providing small businesses with health insurance plans from 9 of the top carriers in the state
Covered California is the is the state health insurance exchange. Eligible individuals and small businesses can purchase private health insurance coverage at federally subsidized rates.
Operating in all 50 states, Delta Dental Plans provide coverage to over 39 million people.
Humana is a Medicare Advantage HMO organization and a stand-alone prescription drug plan with a Medicare contract.
Inter Valley Health Plan offers full-service plans to Medicare eligible customers in portions of San Bernardino, Riverside, O.C. and LA County.
America’s largest not-for-profit HMO, serving 8.1 million members in 9 states and District of Columbia.
Operating in all 50 states, Delta Dental Plans provide coverage to over 39 million people.
SCAN Health Plan is an HMO plan with a Medicare contract. Ranked one of the Best Medicare Advantage Plans in California.
United American is one of the largest nationwide underwriters of individual insurance to supplement Medicare.
Serves over 3 million health plan members and over 9 million specialty members nationwide.
If you have ever been sick or injured, you know how important it is to have health coverage. But if you’re confused about what kind is best for you, you’re not alone.
What types of health coverage are available? If your employer offers you a choice of health plans, what should you know before making a decision? In addition to coverage for medical expenses, do you need some other kind of insurance? What if you are too ill to work? Or, if you are over 65, will Medicare pay for all your medical expenses?
These are questions that today’s consumers are asking; and these questions aren’t necessarily easy to answer.
Call today and let us help you find the right plan for your needs. (714) 695-0674
Frequently Asked Questions
What Is Not Covered?
While HMO benefits are generally more comprehensive than those of traditional fee-for-service plans, no health plan will cover every medical expense.
Very few plans cover eyeglasses and hearing aids because these are considered budgetable expenses. Very few cover elective cosmetic surgery, except to correct damage caused by a covered accidental injury. Some fee-for-service plans do not cover checkups. Procedures that are considered experimental may not be covered either. And some plans cover complications arising from pregnancy, but do not cover normal pregnancy or childbirth.
Health insurance policies frequently exclude coverage for preexisting conditions, but, as explained, federal law now limits exclusions based on such conditions.
You should also remember that insurers will not pay duplicate benefits. You and your spouse may each be covered under a health insurance plan at work but, under what is called a “coordination of benefits” provision, the total you can receive under both plans for a covered medical expense cannot exceed 100 percent of the allowable cost. Also note that if neither of your plans covers 100 percent of your expenses, you will only be covered for the percentage of coverage (for example, 80 percent) that your primary plan covers. This provision benefits everyone in the long run because it helps to keep costs down.
How Do I Get Health Coverage?
Health insurance is generally available through groups and to individuals. Premiums – the regular fees that you pay for health insurance coverage – are generally lower for group coverage. When you receive group insurance at work, the premium usually is paid through your employer.
Group insurance is typically offered through employers, although unions, professional associations, and other organizations also offer it. As an employee benefit, group health insurance has many advantages. Much – although not all – of the cost may be borne by the employer. Premium costs are frequently lower because economies of scale in large groups make administration less expensive. With group insurance, if you enroll when you first become eligible for coverage, you generally will not be asked for evidence that you are insurable. (Enrollment usually occurs when you first take a job, and/or during a specified period each year, which is called open enrollment.) Some employers offer employees a choice of fee-for-service and managed care plans. In addition, some group plans offer dental insurance as well as medical.
Individual insurance is a good option if you work for a small company that does not offer health insurance or if you are self-employed. Buying individual insurance allows you to tailor a plan to fit your needs from the insurance company of your choice. It requires careful shopping, because coverage and costs vary from company to company. In evaluating policies, consider what medical services are covered, what benefits are paid, and how much you must pay in deductibles and coinsurance. You may keep premiums down by accepting a higher deductible.
Options In Insurance is an independent agency, therefore we provide objective information to consumers and small business owners, helping them make informed decisions about their insurance needs. Our service is available to all California residents.