Guest Post: Buying Health Insurance In California Without Being Slimed

"Insurers Curse As Covered California Foils Their Plans Again," a Faustian graphic

Recently, My Health Insurance Company tried to sneak in a change to a different PPO with a third higher premiums and tenfold higher co-pays. I called them and got nowhere.  

Nationwide, open enrollment ended December 15.  That would have meant that bait-and-switch shenanigans, or whatever fraud these evil health insurers had tried to cook up, would have been successful.  I would have been stuck with a way more expensive plan to which the company changed me without my knowledge, or consent.

What follows is a presentation Corporanon wrote up so that others could benefit from what we learned.

Buying Health Insurance In California Without Being Slimed by Corporanon Under the Affordable Care Act, "Open Enrollment," the only time in every year (barring extreme or life changing circumstances) in which you can start or change your health insurance plan, ended December 15, nationwide.  Open enrollment in California, however, continues until the end of January --11:59 p.m., January 31, 2020, to be exact.  This is good news, but it would still be entirely understandable for any adult in their right mind to dread shopping for health insurance from these companies. That they fail to mention the California deadline demonstrates their deceitfulness. A well-informed decision based on the info one can pry out of these snakes is a chimera.  Fortunately, if you live in California, hooray!  Using Covered California (the official State Marketplace under the Affordable Care Act) makes it pretty simple to get well informed for a sound decision.  Here’s why and how: Price: Covered California is the official Marketplace for California. This gives them the right and the power, if you are eligible for a subsidy, to immediately apply that subsidy to discount the monthly premium, instead of making you wait until you file taxes to get that money (back) (see note 1). Financial simplicity: They (Covered California) apply the subsidy automatically, based on income. Anyone whose income (see note) is between 138% and 400% of 2019 Federal Poverty Level (FPL) is eligible. The 2019 FPL was $16,910 for two people, so the eligibility range is between $23,336 and $67,640 (see note 2). Selection: One can buy PPO or HMO coverage on offer from all the California companies. By far the easiest way to do this is to visit Covered California’s website, because you can look at all the plans there. This is also easier than calling Covered California to hear them all by phone. Website is: CoveredCa.com, (for their phone number, see note 3). Selection help: Their enrollment has a very useful brief quiz to help you pick a plan level (bronze, silver, gold) based on anticipated usage. We’ve used it with good results. Info regarding whether a given “provider” (hospital or doctor) is covered by a plan: This is the only aspect in which they are mediocre. It still is better than checking with each insurance company. If they (Covered California) say that a doctor or hospital is in-network, you can bank on it. If they say the provider is not covered, check with the provider (see note 4). Trust: Covered California is more trustworthy than HMOs, insurance companies, and their agents, almost all of whom are dolts. Covered California will fight for you, and even do a three-way call with the insurance company on the line, if you have a billing problem. *** NOTES: 1. To shop and compare, go here. 2. “Income” here means Modified Adjusted Gross Income (MAGI). This is arrived at by taking the Adjusted Gross Income (AGI) off of your tax form. (It is okay to use last year’s, if this year’s is not ready yet.) Then add the following to the AGI, if applicable: (a) untaxed foreign income, (b) non-taxable Social Security benefits, and (c) tax-exempt interest. The total is the MAGI.  Less than the minimum puts one into Medi-Cal; more than the maximum makes one ineligible for subsidy, but insurance can still be bought through Covered California.  3. Covered California: 1-800-300-1506, M-F, 8-8, Sat., 8-6. 4. Your preferred physician may in fact accept your chosen PPO, even though Covered CA does not know it. The provider’s office will be able to tell you conclusively if a given insurance company’s PPOs or HMOs are accepted. (If you find that a doctor accepts one of My Health Insurance Company’s PPOs, for example, then that doctor almost certainly accepts all My Health Insurance Company PPOs. We are assuming other doctors and other insurers do likewise.  PLEASE CHECK THIS.) In fact, doctor’s offices are often ignorant of the plans’ names, so they’ll know they take My Health Insurance Company PPOs, but won’t care if you have, say, the “My Health Insurance Company Gold 93 PPO” instead of the “My Health Insurance Company Bronze 23 PPO”. PPOs work like traditional insurance, so they’re more widely accepted than HMOs. Bottom Line: We are happy with our experience and coverage.  I’ve previously performed significant research on insurance, the hard way, so I know whereof I speak. In short, Covered California makes shopping for health insurance pretty simple.  *** Hoping for a Healthy and Happy New Year for You and Yours, Corporanon

Full disclosure: Neither a female Faust nor Corporanon nor anyone they personally know is connected in any way to Covered California except as a satisfied end user; furthermore this post was conceived of, written, and published without, and with no regard for, the knowledge, authorization, or even tacit approval, however expressed, of anyone other than ourselves.

Be seeing you.