If you’re looking for health insurance in California, you've probably heard some terms floating around that begin with M. Major medical. Minimum essential requirement. Maximum out-of-pocket. Medi-Cal. Why is M such a popular part of the alphabet all of a sudden? Here’s another M word for you—Markets. As in HealthMarkets Insurance Agency. We’re here to help you understand the rest of those M’s, and why they’re important for you to understand if you’re shopping for health insurance in California.
Finding Medical Insurance in California
Check out this short video and learn more about how HealthMarkets Insurance Agency can help you find a great plan in California:
First up: Major Medical
California, you’re a state full of healthy people. Your days are bright and your oranges are sweet; you have waves to surf, mountains to climb, and deserts to trek. But you also have a health insurance issue: in 2013, 15% of your population didn’t have health insurance. That’s more than 5 million California citizens who went without a kind of health insurance called major medical insurance.
Major medical insurance is the kind of insurance that helps take care of things like your visits to the doctor or your trips to the hospital. It’s what most people think of when they think of health insurance, and it’s the kind of insurance we’re counting when we total the uninsured. The problem with going without major medical insurance in California is that the government requires you to have it, and have enough of it. If you don’t, you risk paying a fine on your federal taxes for each month that you’re uninsured.
Furthermore, your insurance must meet the government’s minimum essential requirement. You can find major medical insurance in a few different ways, including a government insurance exchange called the Health Insurance Marketplace (there’s that letter again!) and California’s state exchange Covered California. But if you want access to thousands of licensed agents who can help you compare major medical insurance policies from more than 180 carriers, you should call HealthMarkets. We’re the major medical experts, and we offer you free support 24/7.
If your income is very limited and you’re not sure you can afford to buy major medical insurance or pay the associated fine, you may qualify for Medi-Cal, California’s state medical insurance assistance program. Medi-Cal offers some qualified applicants free medical insurance. HealthMarkets can help you determine whether you may qualify for this program.
So what’s a minimum essential requirement? Whether you get your insurance through a government or state exchange, a private insurance company, or an assistance program like Medi-Cal, your policy will probably have to meet a minimum essential requirement. This means that your policy will need to cover a certain number of required services, including preventive care, hospital visits, mental health care, laboratory testing, and maternity care. Supplemental policies or specialty policies like dental or vision insurance probably do not meet this requirement.
Finally: Maximum out-of-pocket
Since the government has mandated that you obtain major medical coverage that adheres to a minimum essential requirement, it has endeavored to make that coverage affordable. One of the ways it does so is by mandating maximum out-of-pocket expenses for plans bought through a government or state exchange. After you pay a certain amount of money in deductibles, copays, coinsurance, or other out-of-pocket expenses, your insurance company probably has to take care of the rest of your bill.
And, bringing up the rear: Matching!
The HealthMarkets mission is to match you with a policy that meets the minimum essential requirement and provides the major medical insurance that you or your family needs. Call HealthMarkets Insurance Agency today about your needs for medical insurance in California. We’ll get right to work, comparing your needs to plans from the policies of more than 180 national and regional insurance companies. We match you to the ones that work for you; you’ll choose the one that best fits your needs, and voila! You’ll have taken care of all those M’s, right here at HealthMarkets. Now pass the M&Ms, please. We got hungry!