Health plans are divided into five categories to make comparing them easier. The categories are based on the percentage of health care costs the plans pay and the portion you pay out of pocket, including the deductible, copayments and coinsurance. The percentages are estimates based on the amount of medical care an average person would use in a year. The categories are:
Before making a final decision to purchase a policy, closely review the full plan explanation, sometimes called the certificate of coverage or the evidence of coverage, and seek help from the Web brokerage’s agents or other experts if you don’t understand it. Insurers may let you review this this document only after you tentatively choose a plan and are accepted for coverage.
By comparison, the Commonwealth Fund’s Scorecard on State Health System Performance 2015 placed California 26th, but the state jumped 12 spots, to 14th place, in the 2017 Scorecard. While the majority of the state’s health indicators had relatively middle-of-the-road placement, the state fared very well in terms of tobacco use and percentage of the population that suffered from tooth loss (2nd place in both cases). But California ranked 50th in terms of the percentage of children with a medical home.
Now insurers have to cover you regardless of your health history, and they can't charge you more because of medical conditions. You qualify for health insurance even if you're pregnant, have a long-term condition like diabetes or a serious illness such as cancer. Health plans also can't cap the amount of benefits you receive, and they can't make you pay more than a certain amount out of pocket for health care each year. In addition, all individual health plans must cover a standard set of 10 benefits:
Advertiser Disclosure: Some of the offers that appear on this website are from companies which ValuePenguin receives compensation. This compensation may impact how and where offers appear on this site (including, for example, the order in which they appear). The site does not review or include all companies or all available products. For more information please see our Advertiser Disclosure.
2 Telehealth providers participating in the Cigna Telehealth Connection program are independent contractors and separate from Plan network providers. Not all providers have video chat capabilities. Video chat is not available in all areas. PCP referral is not required. Refer to plan documents for a complete description of covered services, including other telehealth/telemedicine benefits. Program availability may vary by location and plan type. See vendor sites for details.