The state of California has a historically low uninsured rate of 7.4 percent. With a population of 39.54 million, having only 2.9 million people left to struggle is quite a feat for a state to pull off. The reasons as to why these people don’t have insurance are for various reasons; the high cost of coverage, not being documented or don’t understand how the system works. Grasping the complex system of health insurance is difficult to do at first glance, but it can be navigated with patience.
The first thing to understand is the types of service there are to choose from. EPOs, HMOs, PPOs and a POS plan are rather similar, but when you start to analyze the small differences they can make a huge difference in what you pay and how you are treated. For example, both an EPO and HMO will cover you were you to see someone in their network. They’ll even cover outside services were it an emergency, however, HMOs usually require you to live in a certain location or to work in a specific area.
A POS plan won’t completely cover you, but you will be able to pay for your needs at a reduced price as long if they’re within their network. You will also need a referral from your doctor in order to see a specialist—or any outside services. A PPO, like a POS, allows you to pay for your services at a discounted price. However, a PPO will let you see services outside your network without a referral, but at an additional cost. While these plans do decide who you see using money as an incentive, the main way you identify how much you pay is through the type of “metal” you choose.
Bronze, silver, gold and platinum are your choices for metals. The more glamorous the metal, the more you’ll have you pay in monthly premiums, but less out-of-pocket. For example, were you to choose a bronze plan you’d have to pay an estimated 388 dollars in monthly premiums; a platinum plan will run you an estimated 583 dollars a month. When you start to compare these costs to the price of being uninsured, it will start to explain health insurance’s importance.
Living in California, you are used to buying most items at a higher rate. Rent is on average much more expensive, but so are the costs of paying for medical services without insurance. Whereas, the use of health insurance will severely lower the costs you’ll have to pay. Looking at the number one killer in California, and the nation—heart disease—you’ll understand why health insurance is vital to your finances.
Now, depending on where you live in California you can pay a vastly different price for recuperation from a heart attack. Were you to live in the Inland Empire, you’d have to pay the estimated total cost of 532 dollars. Those on the Monterey Coast—Monterey, Santa Cruz and San Benito—will have to pay the estimated total costs of 75 dollars. These are incredibly low numbers to pay because of a heart attack. Especially since, the low end total cost of heart attack recovery is 19,000 dollars without insurance.
This price only happens if the hospital doesn’t use expensive equipment or medicine; the high estimated total cost is 82,600 dollars. Of course, depending on the package you have, you can spend more or less in different areas. The fact health insurance companies pay for over 50 percent of the costs saves millions of Californians from bankruptcy. This is why companies, like Insurance Line One, want to make sure everyone is insured. Offering open enrollment all year, you’ll never be vulnerable to the high costs of recovery. Most of this is possible because of the passing of the Affordable Care Act.
Before, health insurance companies placed a cap on how much they’ll pay for your recuperation. This was usually in the low thousands, meaning millions of people were left to pay the high costs these organizations ignored. The Affordable Care Act placed a cap on how much you’ll pay out-of-pocket; individual plans cap out at 7,350 dollars and families have a maximum of 14,700 dollars. Families with more than three children benefit the most from the bill. Being in a big family, it can be difficult to pay for everyone’s insurance and basic survival needs.
Were you to have five children all under the age of 20, they’d all be covered as long as you pay for the three oldest children’s health care packages. Meaning, you, your partner and five children—all under 20—will be covered for the cost of five people, instead of seven. However, were they over 21, you’d need to pay for them individually; until the next three oldest children under 20. Although, they can stay on your plan until they are 26.
Families now have more of an opportunity to insure all of their family members. Individuals are also given more of an incentive to protect themselves from danger. After all, no one has thousands of dollars to drop in a weekend for something they had no control over. With packages starting as low as 150 dollars, you’ll already be paying less than the state and nation’s average.
You’ll also be able to sort through the list of services they offer and pick the one best suited for you. Whether it’s health, dental, life, vision, vehicle or many other forms of insurance, they have the options for you. Filling out the application at the bottom of their page will allow them to get in contact with you to further discuss their affordability. Don’t make your life harder, soothe this traumatizing event with the help of others.
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