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Overpaying for Health Insurance in California? Here's What You Can Do
If your premium went up again and your coverage didn't, you're not imagining it. Here's the checklist we walk clients through.
Are you getting a subsidy you qualify for?
A surprising number of self-employed Californians buy full-price plans directly from a carrier and never apply through Covered California. If your income is under the 400% line, you're leaving money on the table.
Are you paying full price while healthy?
If you're above the subsidy line and in good health, you're paying a guaranteed-issue price for a risk you don't represent. Private shared-network PPOs on Cigna, Aetna and PHCS PPO price on health and are routinely hundreds less per month.
Is your network the one you use?
Many California marketplace plans are HMOs centered on one hospital system. If you drive past in-network hospitals to reach your doctor, or travel, you're paying for a network you can't use. A national PPO fixes that.
Is your deductible matched to your usage?
Healthy people on low-deductible plans overpay every month for a deductible they never reach. Moving to a mid-deductible plan plus an HSA is often the right trade.
California specifics
California regulates non-ACA coverage more tightly than most states, and the state mandate and Covered California's state subsidies change the math for many people, so private options here are narrower and the honest answer is often a careful comparison, not a promise of savings. California has its own individual mandate: residents without qualifying coverage owe a penalty on their state return.
We do this review free, in 15 minutes, for anyone in California. Check your options.