Individual & Family Health Insurance Los Angeles

Health Insurance is a type of coverage that pays for medical and surgical expenses in return for a premium paid to the carrier. Premiums are usually paid on a monthly basis but may also be purchased semi-annually or annually.

The amount you pay for a Health Insurance Plan depends on many factors. When looking for a Plan, some factors taken into consideration include your age, gender, whether you are a smoker, where you live, and whether you are enrolling individually or with family members.

A deductible is a fixed amount that you have to pay out of pocket each year for covered health services before your Health Insurance Coverage begins to pay.
Ex: Let’s say you have a $1,500 annual deductible. You get sick and have to go to the hospital where your bill comes out to $4,000 dollars. You will have to pay your $1,500 and your Health Insurance will cover the remaining 2,500.

After your deductible has been met, a copayment is expected next. A copayment is also a fixed amount for when you visit a doctor’s office and pay a fee for your service. This payment may come in a dollar amount or a percentage amount.

A premium is an amount that is paid for your Insurance Policy.

With many Health Insurance Plans, there is a deductible that has to be met until your plan begins to cover the amount of the prescription.

HMO means Health Maintenance Organization. This plan typically has lower monthly premiums but limits your choices. HMO’s have their own list of doctors and hospitals. Through this plan you choose a primary care doctor and must make a copayment every time you go for a visit. Also, before seeing any specialist, you must first go and see your primary doctor.

PPO stands for Preferred Provider Organization. This plan if more expensive per month but offers more flexibility by not making you choose a primary physician to make choices for you. With a PPO plan, you get to choose from a large list of “In-Network” Doctors and do not need a referral to see a specialist. Every time you go and visit a doctor, you will need to make a copayment.

Covered California, also known as the Affordable Care Act, aims to reduce the amount of premium you pay for your Health Care Coverage. When applying for this coverage, you may get a discount for coverage or get Health Insurance through the Medi-Cal program. Under Covered California, a person may choose whether they would like to be covered under a Bronze Plan, a Silver Plan, a Gold Plan, or a Platinum Plan.