Health Insurance
Health insurance helps cover the cost of medical care, including doctor visits, hospital services, prescriptions, and preventive care. In California, health insurance is available through both Covered California and directly from insurance companies.
Types of Health Insurance Plans
Health insurance plans are typically categorized into four metal tiers:
- Bronze plans usually have lower monthly premiums and higher out-of-pocket costs.
- Silver plans balance monthly premiums and out-of-pocket costs and may qualify for additional savings through Covered California.
- Gold plans generally have higher monthly premiums with lower out-of-pocket costs.
- Platinum plans have the highest monthly premiums and the lowest out-of-pocket costs.
All plans cover essential health benefits, but costs and networks vary.
Covered California vs Off-Exchange Plans
Covered California plans are purchased through the state marketplace and may include financial assistance based on household income.
Off-exchange plans are purchased directly from insurance companies and do not include subsidies, but may offer different plan options or networks.
Both types of plans must meet state and federal coverage requirements.
Provider Networks
Each health insurance plan has a provider network that determines which doctors, hospitals, and specialists are covered.
Common network types include:
- HMO (Health Maintenance Organization)
- PPO (Preferred Provider Organization)
- EPO (Exclusive Provider Organization)
Using providers outside of a plan’s network may result in higher costs or no coverage.
Prescription Drug Coverage
Health insurance plans include prescription drug coverage, but each plan has its own drug list, called a formulary.
Costs for medications can vary depending on:
- The specific drug
- The tier it is placed in
- Whether a generic or brand name is used
Enrollment Periods
Most people can enroll in health insurance during Open Enrollment, which occurs once per year.
Outside of Open Enrollment, you may qualify to enroll if you experience a qualifying life event, such as losing coverage, getting married, having a child, or moving.
Getting Help Choosing a Plan
Choosing the right health insurance plan depends on factors such as budget, healthcare needs, preferred doctors, and prescription medications.
A licensed insurance agent can help explain plan options, compare coverage, and answer questions at no additional cost.
Contact & Support
Can I speak with a licensed agent?
Yes. Licensed California insurance agents are available to answer questions and provide guidance at no additional cost.
Prefer to contact us directly?
Call 800-341-1165 or email health@californiainsurancecenter.com.
Contact form
By submitting this form, you authorize California Benefits Insurance Center to contact you regarding your request by phone, email, or text message. Consent is not a condition of enrollment.
We typically respond within one business day. If your request is urgent, please include your preferred contact method and best time to reach you.
California Benefits Insurance Center is an independent insurance agency. Submission of this form does not guarantee coverage or enrollment. Quotes and plan availability are subject to carrier underwriting, eligibility, and applicable enrollment periods.