March 29, 2024

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Health Insurance Guys: New California family needs a better health care plan | The Health Insurance Guys

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Al: You just missed our final COVID-19 open enrollment extension. Usually our open enrollment ends around February or March. This year, each month has had an additional extension right up to Aug. 31. The “official” open enrollment for 2021 starts Nov. 1 this year and goes until Jan. 31 next year.

By the way, beginning Sept. 1, there is another open enrollment for people in the counties impacted by the wildfires — a “special event” qualifying event.

Anyway, our reader is eligible to begin coverage for his family as early as Oct. 1 so long as he starts the application before Sept. 15. If started after Sept. 15, the earliest date would be Nov. 1.

Tom: Going back to the Kaiser Platinum Plan, it includes no deductible, $15 office visits with a primary care physician and a maximum out-of-pocket expense of $4,500 for an individual. Meanwhile, the two Gold Kaiser Plans also had no deductible, but primary car physician office visits are $30 and the maximum out of pocket is $7,800 per individual.

As with all HMOs, there are copays and coinsurance for just about everything. For example, inpatient hospital on the Platinum Plan is about $250 to $300 per day up to six days, while the Gold Plans are $600 per day up to six days. Although the Gold Plans are $200 to $400 per month cheaper than the Platinum, the copays and coinsurance are higher for almost every service including the price of medications.

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