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You made the reservations six months ago. You've packed everything you could possibly need for your vacation, from flip-flops to sunglasses. But even the best planned trips can be derailed by circumstances beyond your control. Learn how to protect yourself and family during a vacation.
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Frequently Asked Questions:
Frequently Asked Questions about health insurance:
(we have all of these questions answered on our YouTube Channel and more resources. Please visit us & Subscribe to us on YouTube and stay up to date on this information)
- What is health insurance? - Health insurance is a type of coverage that helps individuals pay for medical expenses and services.
- How does health insurance work? - Health insurance works by individuals paying premiums to an insurance company in exchange for coverage of medical expenses, subject to certain deductibles, copayments, and limits.
- Why do I need health insurance? - Health insurance provides financial protection against unexpected medical expenses and ensures access to necessary healthcare services.
- What types of health insurance plans are available in California? - Common types include HMO, PPO, EPO, and POS plans, each with different networks and coverage options.
- How do I choose the right health insurance plan for me? - Consider your healthcare needs, budget, preferred providers, and coverage options when selecting a plan.
- Can I get health insurance if I have pre-existing conditions? - Yes, under the Affordable Care Act, insurance companies cannot deny coverage or charge higher premiums based on pre-existing conditions.
- How much does health insurance cost in California? - Costs vary based on factors like plan type, coverage level, age, and location. It's best to obtain personalized quotes to determine specific costs.
- Can I get financial assistance to help pay for health insurance? - Yes, individuals with certain income levels may qualify for subsidies or tax credits through programs like Covered California.
- What is the difference between HMO and PPO plans? - HMO plans require referrals and have a primary care physician, while PPO plans offer more flexibility in choosing providers.
- What does "deductible" mean in health insurance? - The deductible is the amount individuals must pay out-of-pocket for covered services before the insurance company starts contributing.
- How does copayment work? - Copayment is a fixed fee individuals pay at the time of receiving specific healthcare services.
- What is an out-of-pocket maximum? - The out-of-pocket maximum is the limit individuals pay for covered services in a policy year, after which the insurance company pays 100%.
- Are preventive services covered by health insurance? - Yes, most health insurance plans are required to cover preventive services without cost-sharing, such as vaccinations and screenings.
- What is the open enrollment period for health insurance in California? - Open enrollment is a specific period during which individuals can enroll in or make changes to their health insurance plans. (typically from November 1 - January 31).
- Can I get health insurance outside of the open enrollment period? - You may qualify for a Special Enrollment Period if you experience a qualifying life event, such as marriage or loss of job-based coverage.
- How do I apply for health insurance in California? - You can apply through Covered California, directly with insurance companies (Kaiser, Blue Shield, Anthem Blue Cross, VSP, etc ) or with the help of a licensed insurance agent or broker.
- What is Covered California? - Covered California is California's health insurance marketplace, where individuals can shop for and enroll in health insurance plans.
- Can I keep my doctor with my health insurance plan? - It depends on the specific plan and provider network. Check if your doctor is in-network before choosing a plan.
- What is a network in health insurance? - A network is a group of healthcare providers (doctors, hospitals, clinics) that have contracted with an insurance company to provide services at discounted rates.
- How do referrals work in HMO plans? - HMO plans often require a referral from a primary care physician to see a specialist.
- Is dental included in the medical insurance? For adults, dental insurance is a separate policy. Dental plan rates are as low as $8/month for HMO plans and $50/month for PPO plans.
- Is vision care included in the medical insurance? For adults vision insurance is a separate policy. There are plans available for as low as $15/month (annual contract is required for vision plans)
- What is Medicare? Medicare is a federal health insurance program in the United States primarily designed for individuals aged 65 and older. It also provides coverage for certain younger individuals with disabilities or end-stage renal disease. Medicare is divided into different parts, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage).
- What is Medi-Cal? Medi-Cal is California's Medicaid program, a joint federal and state health insurance program that provides free or low-cost medical coverage to individuals and families with low income.
- Is travel insurance covered by regular medical insurance? Typically for travel outside of US it's best to get a separate international travel insurance as it provides financial protection against unexpected events such as trip cancellations, medical emergencies abroad, lost baggage, or travel delays, giving travelers peace of mind and potentially saving them from significant expenses. For visitors and tourist to the US it's also advisable to apply for a visitor insurance while travelling. The rates are affordable and short term coverage is available for as low as 6 days!
What is the maximum income to qualify for CoveredCA?
Can legal immigrants receive Medi-Cal benefits or apply for a CoveredCA health plan?
What is Covered by Dental Insurance?
Do I have to pay a penalty if I don’t have health insurance in 2018 or 2019? do i need form 1095-A?
What are exemptions from health insurance tax penalty and who qualifies for exemption?
What are 1095 Tax Forms for Health Care 1095 A, 1095 B, 1095 C?
Why is Health Insurance expensive?
How to find a health insurance broker?
What is the difference of PPO and HMO?
What do you need to know about dental insurance?
What do you need to know about vision insurance?
How to save money on doctor’s visits?
What is covered by Kaiser plan?
What is covered by BlueShield plan?
What is covered by Valley Health PLan?
My Blog
What is the maximum income to qualify for Obamacare subsidies?
September 11, 2019|Health Insurance
The table above can help you easily navigate the eligibility for you and your family based on your household size and the household income.
You can get a quote and compare medical plans for you and your family on our web site:
https://insurancecenterhelpline.com/coveredca
(choose among major medical plans such as Kaiser, BlueShield, Anthem BlueCross, HealthNet, Oscar, VHP, etc)
The Affordable Care Law is still in force for year 2020. Next year, the subsidies are more generous and will allow even more families to qualify for low cost health insurance in California.
The table above will help anyone figure out the eligibility for either CoveredCA subsidized private plans or Medi-Cal (Medicaid).
For example a family of 4 with income less than $154,500 will qualify for lower cost health insurance.
Also, it is worth to mention that while the subsidies available in California are quite generous, the penalty has been reinstated in the state starting with year 2020.
The open enrollment to get health insurance for the year 2020 is October 15, 2019 through January 31, 2020. You can read our previous post on this topic- https://insurancecenterhelpline.com/our-blog/f/open-enrollment-2020---when-can-you-buy-health-insurance
How to read the table?
Feel free to reach us in case you have questions or unsure how to interpret the above information.
To make it easy, look at your household size and income to determine what program you can qualify for. For example, if your household size is 1 person (just you) and your income is bellow $17,237/year then you qualify for Medi-Cal (this is how Medicaid in called in California). If your income is above $17,237/year but less than $74,940/year then you qualify for the APTC (advance premium tax credits ) or subsidy that will help you pay less for health insurance.
Covered California uses FPL (federal poverty level) limits from the prior year to determine eligibility for its programs as required by regulation.
Here are the columns associated with Covered California eligibility ranges:
Premium Assistance 138% - 600% FPL
Enhanced Silver Plans 138% - 250% FPL
• Silver 94 138% - 150% FPL
• Silver 87 over 150% - 200% FPL
• Silver 73 over 200% - 250% FPL
2020 FPL values as published by the Department of Health and Human Services.
Medi-Cal Eligibility
Medi-Cal uses FPL limits of the current year to determine eligibility for its programs. The column headings shaded in purple are associated with eligibility ranges for Medi-Cal programs:
• Medi-Cal for Adults up to 138% FPL
• Medi-Cal for Children up to 266% FPL
• MCAP: over 213% - 322% FPL
• CCHIP: over 266% - 322% FPL
So, what is the income limit for 1 person to qualify for Medi-Cal?
If you look at the table, you can see that the income limit for 1 person to qualify for Medi-Cal in California shall be less than $17,237/year
Got questions? please feel free to reach out to us. We will be glad to assist.
Frequently Asked Questions about health insurance:
(we have all of this questions answered on our YouTube Channel and more resources. Please visit us & Subscribe to us on YouTube and stay up to date on this information)
When is the open enrollment to get health insurance for 2020?
When is the open enrollment to get Health Insurance in 2019?
What is Covered by Dental Insurance?
How to compare health plans for 2019?
Do I have to pay a penalty if I don’t have health insurance in 2018 or 2019? do i need form 1095-A?
What are exemptions from health insurance tax penalty and who qualifies for exemption?
What are 1095 Tax Forms for Health Care 1095 A, 1095 B, 1095 C?
Why is Health Insurance expensive?
How to find a health insurance broker?
What plans are in CoveredCa in 2018?
What is the difference of PPO and HMO?
What do you need to know about dental insurance?
What do you need to know about vision insurance?
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About Us
Our Commitment to Quality
Insurance Center Helpline, Inc. is an insurance agency located in the San Francisco Bay Area with clients throughout California. The agency was established in 2013 (rebranded in 2018) for one purpose - To service the local community with understanding of their health insurance coverage options. We completely realize that shopping for health insurance can be confusing, frustrating, and most importantly it can be a complicated process - especially now, with changes brought by The Affordable Care Act (ACA). We will work with you, one-on-one, to educate you on how health insurance works - from acquiring a plan to understanding your plans benefits, and to how it can be used to pay for medical expenses. In the end, we hope to educate you on the current marketplace and to provide you with the information needed to choose a plan of insurance that best meets your financial and medical needs.
What makes the Insurance Center Helpline, Inc. unique is that we focus solely on the needs of our clients. We listen. We talk. We choose a health insurance product that works and best fits your individual, family or small business needs.
We recognize that no two individuals, families or businesses are alike – and the type and level of coverage needed will be equally unique. We will help you obtain the best possible plan at the best possible price for the most comprehensive coverage.
How We Can Help You
We will help you find a health insurance plan that will allow you to have access to top doctors, clinics and hospitals
See the Difference
We work with all the insurance carriers in California, so we can shop and Compare various options. We also work with CoveredCa and will be glad to assist with your enrollment, renewals & issues.