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In some instances the policyholder has to pay higher co-insurance to avail the freedom of getting treated by the physician of his choice. California Health Insurance plans also have the provision for letting a policyholder start what is known as HSA. It is a tax-free account to which he can contribute for his medical expenses.
California Group Health Insurance, like the group health insurances of every other state, is a single policy designed to give medical cover to a group of people working under the same employer. This California Health Insurance plan is generally availed by the employer, by which he brings all his employees under one single umbrella of coverage. However, different types of policies are available within California Group Health Insurance plans.
A PPO or Preferred Provider Organization allows the policyholder to travel out of the insurance provider’s network for medical treatment. This is a comparatively costly California Health Insurance plan because the policyholder will have to pay a separate co-insurance for availing this out of network medical aid. Co-insurance is a provision by which he will have to bear a percentage of the medical costs. A PPO policyholder has also got to pay a deductible. The policy, however, allows the individual to seek medical help from any specialist he chooses. Though expensive, this type of California Group Health Insurance policy gives the insured individual better treatment options.
Another policy option under California Group Health Insurance is HMO or Health Maintenance Organization. Those who hold this policy do not have the freedom to move out of the insurance provider’s network. Even to see a specialist, he has to be referred to the specialist by a primary care physician. By and large HMO works out cheaper than PPO mainly because it has a much lower co-insurance and does not involve a deductible at all. But under it the policyholders do not have the benefit of HSA or Health Savings Account. HSA is a feature, which allows the user to start a tax-free account where he can deposit money and earn an interest and the amount can be used for medical expenses. For a California Health Insurance plan to be eligible for HSA, it must at least have a yearly deductible of more than $1000.
Both the PPO option and HMO option include what is known as co-payment where the insured has to bear a percentage of the cost of the doctor’s fee and other lab expenses. There is a third type of policy under California Health Insurance referred to as POS or Point of Service. This basically works like an HMO only, but here the policyholder can choose to get treated by the specialist he prefers, as in the case of PPO, instead of having to get a primary care physician to recommend him. Because the policyholder himself decides where to seek medical care, he will also have to pay a higher co-insurance to cover this. Simply put, this plan functions on the basis of how the individual decides to use the California Group Health Insurance at the ‘point of service’.
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