Health Insurance Plans Available on Covered California

There are different types of Covered California health insurance plans designed to meet different needs. Some types of plans restrict your provider choices or encourage you to get care from the plan’s network of doctors, hospitals, pharmacies, and other medical service providers. Others pay a greater share of costs for providers outside the plan’s network. Here is an overview of the types of marketplace plans available to you.

Types of Marketplace plans

Depending on how many plans are offered in your area, you may find plans of all or any of these types at each metal level – Bronze, Silver, Gold, and Platinum. In general, Bronze plans are expected to cover 60% , Silver 70%, Gold 80% and Platinum 90% of expected costs. 

This is a list of the available benefit designs available at Covered California:

Some examples of plan types you’ll find:

• Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness.
• Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
• Preferred Provider Organization (PPO): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral but you will pay a higher share of the cost of care.

For more information about the different options visit www.coveredca.gov

There are pro’s and con’s for each option. It’s important to select the right option based on your needs. Contact us for guidance in selecting the right policy for you and your family. There is no cost to you for our help.