What is covered by Kaiser Permanente California Individual and Family Health Insurance Plans

Today we will be looking at the health insurance coverage for year 2018 and we'll explore the plans offered by Kaiser in California in 2018 Kaiser offers plans on exchange and alfaye exchange Kaiser only offers HMO plans on the individual market most of their plans offer the same benefits on and off the exchange but there are certain plans.

That are only available directly I'll go over in more details and provide specifics for this type of plans later on in the video also I will have specific summary of benefits or all of the plans offered by Kaiser for year 2018 I will post links under this video if you have specific questions or would like to get an exact cost estimate for.

Your plan or you just need a friendly advice please feel free to reach me directly any time I am an independent insurance agent in California I also work with covered California and will be able to help you with selecting a low-cost or subsidized health insurance plan before proceeding with the video I also want to clarify a few things as of.

Today the ACA Affordable Care Act is the law of the land this means that consumers must elect the health plan during open enrollment which is November 1st 2017 through January 31st 2018 if you apply through covered California the federal open enrollment is shorter and it ends on December 15 2017 also the plans presented in this.

Video are individual plans offered in California again please watch this video until the end as I will give away free tips and tricks that will help you choose a health plan and save money okay so let's start with the basic basics there are four categories of health insurance plans bronze silver gold and platinum this categories show how you.

And your plan share the cost plan categories have nothing to do with the quality of care there is also a catastrophic plan for those that qualify and it's usually for those who are under the age of 30 let's talk about bronze plans now this are usually the high deductible plan on average your health plan pays 60% of.

Your medical expenses and you pay 40% I will go over the details for these plans shortly silver plans are the most popular ones on the market so far on average your health plan pays 70% of your medical expenses and you pay 30% in some cases individuals may qualify for an enhanced silver plan this means that when they choose a silver plan they have.

Based on their income enhanced out-of-pocket savings through lower co-pays coinsurance and deductibles individuals and the savings categories get the benefits of a gold or platinum plan for the price of a silver plan this plans are only available on the exchanges feel free to reach me and I'll help you understand if you qualify for.

Enhanced silver plans let's look at the gold front now gold plans on average of my health plan pays 80% of your medical expenses and you pay 20% this plan does not have a deductible and let's move on to the platinum plan on average your health plan pays 90 percent of your medical expenses and you pay 10% this plan does not have a deductible and now.

Let's take a look at a comparison of health plans for year 2018 here are the metal categories and coverage for a year 2018 there are a few things to remember benefits shown in blue are not subject to any deductible white corner is subject to a deductible up to the first three visits copay is for any combination of services and which.

Includes primary care and specialist Urgent Care for the first three visits as well after three visits they will be at full cost until the medical deductible is met let's take a closer look as I said for bronze plans you don't pay the deductible for the first three visits the lamp is $40 copay and is not subject to deductible the annual.

Wellness exam which is preventive is included at no extra cost the copay for the primary care visit and Urgent Care is $75 and specialists visit 105 dollars this might be a good plan for those that are healthy and rarely go to the doctor obviously if you need more care you will have to pay more out-of-pocket money the maximum.

Out-of-pocket you pay is seven thousand for one individual or fourteen thousand for the family okay so let's look at the silver plan the silver plan has a lower deductible there are no restrictions on how many times you can visit the doctor and again the area that is highlighted in light blue is not subject to deductible you will pay deductible.

Mostly when you are hospitalized I will add the detailed summary of benefits under the video for the full description once is available the gold plan has no deductible the co-pays and coinsurance are lower than those for the silver plan this plan costs more each month but the insurance pays on average 80% of your medical cost and you pay the rest which.

Is 20% the platinum plan has no deductible the co-pays and coinsurance are lower than those for the gold plan this plan costs more each month but the insurance pays on average 90% of your medical cost and you pay the rest obviously the platinum plan has the highest premium each run if you are.

Healthy and readily go to the doctor it might not be a good idea to buy the most expensive plan on the market right now as I said in the beginning of the video I'll share some secrets with you about selecting a health plan that will fit your needs and save you money at the same time so how do you decide which plan is right.

For you start by thinking about your past and future medical bills for example let's say you're healthy most of the time and don't expect to meet costly medical services during the year then a bronze plan that has the lower price tag and pays for a lower portion of your eligible medical bills may be a good choice for you on the other hand let's.

Say you know you have a medical condition that will need care or you have an active family with children who play sports then a gold or platinum plan that pays for more your medical costs may be a better fit for you also it is very important to look at the summary of benefits for any plan you are.

Seriously considering this document tells you what medical services the plan pays for and perhaps most important those it does not think for make sure you like the plan type for example a health maintenance organization or an HMO will require you to have a primary care doctor and get referrals for any specialist you want to see a preferred.

Provider organization or a PPO will give you more leeway in choosing doctors also check the plans provider network directory to make sure your primary care doctor is listed if you want to keep that doctor you can also call your doctor's office and ask whether they accept the specific plan you are considering check the plans drug.

Formulary which is the list of covered drugs to make sure any prescription medication you take our included thanks for watching please like share and comment under the video love this video don't forget to share your happiness with your friends and please please support us by subscribing to our Channel.


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