California Health Insurance, California Health Insurance Quote, California Health Insurance Plans

By: EconomyWatch   Date: 26 May 2010

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When it comes to health insurance options and insurance, each state is slightly different.  In this article, we wanted to discuss options for a California health insurance plan by providing some of the basics regarding the way in which this state has health insurance established.  We will begin by looking at the insurance network for this state specific to HMO, PPO, and EPO types of coverage.

Up to the mid-1980s, California health insurance was uncomplicated.  At that time, people could visit whatever doctor wanted and regardless of choice, the amount paid by the insurance company would be the same.  However, a new system often referred to as “managed care” was introduced, which started a variety of new plans to include HMO, PPO, and EPO.  Just as states have different insurance offerings for health insurance, these plans are also different.

With costs skyrocketing, insurance companies knew that changes were in order.  Therefore, the PPO California health insurance plan was developed, which meant that if people chose this particular plan, doctors would see a greater number of patients and patients would benefit from discounts as high as 60%.  In this case, a doctor’s office visit typically costing $100 would now cost anywhere from $50 to $70 depending on the actual discount being offered.

However, people were also offered the chance to go with California health insurance in the form of an HMO.  The difference was that for every person a doctor could get to become a patient, a bonus of $50 a month would be paid.  The challenge with the HMO is that to enjoy discounts, doctors would have to increase business significantly.  Keep in mind that regardless of choosing a PPO or HMO for California health insurance, each insurance company and treating doctor would have a slight variation as to what they actually offer.

The market for a California health insurance plan remained relatively stable until the early to mid-1990s.  By 1998, premiums for this new “managed care” system had risen dramatically.  While the basics of each plan stayed the same, actual savings enjoyed by patients, and discounts paid to doctors ended up decreasing over time.  Today, it is important to get a California health insurance quote from a variety of companies as a way of finding the best coverage and for the lowest price.  The following is a rundown of each of these plans so you can see what they are and how they differ.

•    PPO – This acronym stands for “Preferred Provider Organization”, which means that patients have the right to choose whatever doctor wanted within a network of providers.  The list of options is extensive for doctors but also for hospitals.  Because of the freedom for a PPO, people are not locked into seeing any single doctor or going to one particular hospital.  With a PPO California health insurance plan, payment is made along the way.  This means patients would pay a percentage or a set amount for the deductible.  Unfortunately, when choosing a doctor or hospital outside the network, savings is less and services could be more expensive.
 
•    HMO – In this case, HMO stands for “Health Maintenance Organization”, which means people would choose the primary doctor at the start of the plan.  From there, people would see that doctor going forward and go to the hospital of which that doctor is associated.  Although an HMO is more structured than a PPO, this type of California health insurance means people would pay less money out of pocket, making it a popular choice.

•    EPO – For this, “Exclusive Provider Organization”, doctors and hospitals would be the same as for a PPO but the difference is that people would have no out of network benefits.  Therefore, if seeing a doctor out of the service network, the individual would not receive any benefits.


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