Are you in need ofhealth insurance in California, but don’t know where to start? With so many options available, it can be overwhelming to know what type of plan to choose.
Luckily, California has a robust health insurance market that offers a range of plans to fit the needs and budgets of individuals and families. In this article, we’ll dive deeper into some of the key questions you may have about buyinghealth insurance in California.
Benefits of finding your California Insurance Plan through eHealth
We help you make choices that fit your needs
Our online tools and filters help you make the health insurance choice that’s right for you.
You won’t pay more for the same plan
There’s no obligation for our services and you’ll pay the same price offered by insurance companies you know and trust.
Expert help at your fingertips
We’re available 24/7 by chat, email or phone.
How Health Insurance Covers Expenses
Health insurance is designed to protect you from substantial medical costs. The insurer identifies the services covered by the plan (e.g., ACA essential benefits) and the cost-sharing arrangement—which determines the portion of eligible healthcare costs the insurer will pay and the portion you will pay.
Once you buy an insurance policy, you need to pay a premium payment either monthly or annually. With this payment, you get the assurance from your insurance provider that you will receive coverage for your healthcare bills that are associated with covered conditions and scenarios. However, even with this coverage, you need to cover certain charges out-of-pocket to utilize affordable health insurance in California. But don’t worry, there’s a limit on what you will be required to pay out-of-pocket for covered care.
Deductible
This charge is a predefined annual limit that you need to spend before your insurer starts with their coverage.
Copays
This is a flat charge against each associated medical care bill. It is typically applied after you cover your deductible.
Coinsurance
This cost is a percentage of your healthcare bills and typically kicks into effect once you have paid your deductible.
Out-Of-Pocket Maximum
This is an annual limit that puts a threshold over how much you spend on your deductibles, coinsurance, and copays. After you meet this limit, your insurance company pays for your medical expenses for the rest of the year.
Types of California health insurance plans
Your healthcare needs and budget are as unique as you are, which is precisely why our California plans come in a variety of price levels, each characterized by a distinct metallic rating: Bronze, Silver, Gold, and Platinum. These ratings offer an intuitive way to gauge the plan's cost-sharing framework.
Financial assistance to help cover health insurance costs is available for those who qualify, so it’s easier to stay on budget and on top of your health
Bronze
These plans, typically with lower monthly premiums, are geared towards those who require minimal coverage or mainly emergency services. They involve higher out-of-pocket expenses when care is needed.
Monthly cost
Deductible
Silver
Silver plans strike a balance between monthly premiums and out-of-pocket costs, suitable for regular healthcare usage.
Gold
Gold plans, with higher premiums, reduce out-of-pocket costs, making them ideal for those with frequent healthcare needs.
Monthly cost
Deductible
Platinum
Platinum plans offer the most comprehensive coverage with the highest premiums but the lowest out-of-pocket costs, perfect for those with extensive healthcare requirements.
Monthly cost
Deductible
California Medical Insurance Statistics
Consider the following statistics about health care coverage in California:
38,940,231
Total California Residents
8%
Total Uninsured California Residents
15,973,004 (Total Medical Enrollment)
Total California HMO enrollment
$8,083
Avg annual employee premium in California employer-sponsored plan (after employer contribution)
$4,181
Avg California hospital cost per inpatient day (before insurance)
Source data according to the
Kaiser Family Foundation: Health Insurance Coverage of the Total Population, states (2007-2008), U.S. (2008); Total HMO Enrollment, July 2008; Average Single Premium per Enrolled Employee; For Employer-Based Health Insurance, 2008; Hospital Adjusted Expenses per Inpatient Day, 2007
Find a California health insurance plan
Explore a diverse range of private health insurance plans tailored for individuals, families, and small businesses in California. Discover a variety of options from top health insurance providers that cater to your needs. Whether you're in Los Angeles, San Diego, San Francisco, or any city in between, take the next step and shop the different plan types to find the perfect fit for you.
Health insurance plans for every stage of life
Dental Insurance Plans
May have a relatively low monthly premium. Can cover everything from routine cleanings and fillings to more comprehensive procedures.
Find Dental Insurance >
Vision Insurance Plans
Can cover annual eye exams. May reduce the cost of contact lenses or glasses.
Find Vision Insurance >
Short Term Insurance Plans
Designed to provide health coverage on a temporary basis. Short-term plans offer limited coverage at affordable prices. Easy to enroll and can start in just a few days.
Find Short Term insurance >
Medicare Insurance Plans
Part A covers hospital expenses, skilled nursing facilities, hospice and home healthcare services. Part B, for a reasonable monthly premium, provides outpatient care such as doctor visits, x-rays, and preventative care. You can also shop plans that potentially reduce your costs for prescription medications.
Find Medicare Plans >Frequently asked questions
How is health insurance in California?
California residents can expect to pay an average of $487 per person* for a major medical individual health insurance plan. Prices will vary and premiums can be lower if you are in good health.
| Metal Level | Average Monthly Premium* |
|---|---|
| Bronze | $486 |
| Silver | $557 |
| Gold | $715 |
| Platinum | $942 |
* This is the average price of a plan available from eHealth in California, but actual prices available depend on zip code, age, gender, and other factors. Get a personalized quote to see what may be available for you.
How to get health insurance in California?
California residents can sign up for ACA health insurance plans via the state marketplace (Covered California) or a licensed health insurance broker like eHealth. You can only sign up for an ACA plan during the annual open enrollment period, unless you qualify for a special enrollment period.
What is the best health insurance in California?
The “best” health insurance plan for you depends on your unique needs and budget. Covered California offers a wide range of health insurance plans from top insurance companies, including Kaiser Permanente, Blue Shield, Anthem Blue Cross, and Health Net. It’s important to carefully review the plan benefits, costs, and provider network before making a decision.
Do you have to have health insurance in California?
California requires all residents to have health coverage to avoid the individual mandate penalty. In 2020 California implemented state-mandated coverage and a state-based premium subsidy. California has allocated state funds to provide premium subsidies to low-income Californians to promote health insurance coverage for all Californians.
What's the cheapest health insurance in California?
The cheapest health insurance in California starts for as low as $167 per person for major medical plans.*
| Metal Level | Lowest Monthly Premium* |
|---|---|
| Bronze | $167 |
| Silver | $182 |
| Gold | $235 |
| Platinum | $271 |
* This is the lowest-price Bronze plan available from eHealth in California, but actual prices available depend on zip code, age, gender, and other factors. Get a personalized quote to see what may be available for you.
What type of health insurance marketplace does California utilize?
In order to make California private health insurance and government healthcare plans more accessible, the Golden State operates its own health insurance marketplace by the name of Covered California. Through this platform, you can access individual and family health insurance plans through private providers and government-funded policies.
When can I enroll in an ACA-compliant plan in California?
Typically, enrolling in an ACA-compliant plan through the Covered California health insurance exchange provides you with one of the longest healthcare enrollment periods in the United States. California’s open enrollment period starts on November 1 and ends on January 31. In order to enroll in an ACA health plan outside of the open enrollment period, you will need to qualify for a special enrollment period.
Types of Health Insurance Plans in California
There are several types of health insurance plans available in California, each with its own set of benefits, costs, and provider networks. Here are some of the most common types of health insurance plans:
- Health Maintenance Organization (HMO) plans: HMO plans require you to choose a primary care physician (PCP) who will be your first point of contact for all of your healthcare needs. Your PCP will refer you to specialists within the HMO’s network, and you will generally need a referral from your PCP to see a specialist. HMO plans tend to have lower out-of-pocket costs, but less flexibility in choosing providers.
- Preferred Provider Organization (PPO) plans: PPO plans give you more flexibility in choosing your providers, but may have higher out-of-pocket costs. With a PPO plan, you can see providers both inside and outside of the plan’s network, but you will generally pay more if you go out-of-network.
- Exclusive Provider Organization (EPO) plans: EPO plans are similar to PPO plans in that they give you more flexibility in choosing providers, but generally have lower out-of-pocket costs. However, with an EPO plan, you cannot see providers outside of the plan’s network.
- Point of Service (POS) plans: POS plans are a hybrid of HMO and PPO plans. Like an HMO plan, you will need to choose a PCP who will refer you to specialists within the plan’s network. However, you may also have the option to see providers outside of the network for a higher cost.
Can I buy my own health insurance in California?
Yes! Whether you are self-employed, retired, or simply do not have access to employer-sponsored health insurance, you can purchase your own health insurance in California. You can do this through Covered California, the state’s health insurance exchange, or directly from insurance companies.
What low-cost health insurance options are available in California?
California offers a range of low-cost health insurance options for individuals and families. Medi-Cal is a state program that provides free or low-cost health coverage to eligible individuals with limited income. Covered California also offers subsidies to help reduce the cost of health insurance for those who qualify based on income.
Do you qualify for Medi-Cal benefits?
Medi-Cal is a state program that provides free or low-cost health coverage to eligible individuals and families with limited income. To qualify, you must meet certain income and residency requirements. You can apply for Medi-Cal through Covered California or directly through your county’s social services department.
Who Qualifies for Medi-Cal?
Medi-Cal is a state program that provides free or low-cost health coverage to eligible individuals and families with limited income. To qualify for Medi-Cal, you must meet certain income and residency requirements.
In California, you may be eligible for Medi-Cal if:
- You have an income at or below 138% of the federal poverty level (FPL) for your household size
- You are pregnant and have an income at or below 213% of the FPL
- You are under 19 years old and have an income at or below 266% of the FPL
- You are 65 years or older, blind, or have a disability and have an income at or below 138% of the FPL
To apply for Medi-Cal, you can either apply online through Covered California or directly through your county’s social services department.
What are some of the main insurance providers in California?
California has a robust health insurance market, with many top insurance providers offering plans. Some of the main insurance providers in California include Kaiser Permanente, Blue Shield, Anthem Blue Cross, Health Net, and Molina Healthcare. Each provider offers a range of health insurance plans with different benefits, costs, and provider networks.
What to Consider When Choosing a Health Insurance Plan
When choosing a health insurance plan in California, there are several factors to consider. Here are some key questions to ask yourself:
- What are your healthcare needs? Consider what types of services you may need in the coming year, such as doctor visits, specialist care, prescription medications, or hospitalizations.
- What is your budget? Health insurance plans can vary widely in cost, so it’s important to consider what you can afford. Be sure to look not only at the monthly premium, but also at the deductible, copays, and coinsurance.
- Which providers are in the plan’s network? If you have a preferred doctor or hospital, make sure that they are covered under your plan.
In conclusion, buying health insurance in California can seem daunting, but there are many options available to fit your needs and budget. Whether you qualify for Medi-Cal or choose to purchase a plan through Covered California or directly from an insurance provider, it’s important to carefully review your options before making a decision. As a healthcare company dedicated to serving Californians, we’re here to help guide you through the process and find the right plan for you.
