California individual and family health plan recommendations

California health plan recommendations

The good news about individual and family health insurance in California is that there are many reputable companies to choose from. The downside is that there are just TOO MANY plans to choose from!

Therefore, before you begin your instant health insurance quote, we recommend you take a few minutes to read through this guide to help you narrow down your choices to the plans that we like and that so many of our customers have selected over the years.

The plans are organized by type of consumer (single, family, etc.), however all plans can be purchased for any category of shopper. Therefore, be sure to read through all of the plans described below.

Which category below fits your needs? ...

I am a healthy single person ... I am looking for something inexpensive. I don't mind paying out of pocket for the smaller items, but I want to know that I am covered for any major illness or accident.

Our recommendation...

Option 1) Health Net of California SmartChoice PPO
(maternity not covered)

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These plans from Health Net are advantageous because as the name implies they are "Simple" to understand and affordable. Basically you have a deductible to pay, and then after you satisfy the deductible you get 100% coverage on everything from doctor's visits to emergency room visits, to hospitalization. A nice feature of the Health Net SimpleChoice plans is that for woman, your annual GYN visit is covered with a small office visit copay and that's it. This plan also covers generic AND brand name drugs, so even if you need expensive drugs now or later, you are covered. There are several deductibles to choose from as you can see here:

Health Net SmartChoice 15 PPO =   $1500 annual deductible
Health Net SmartChoice 25 PPO =   $2500 annual deductible
Health Net SmartChoice 35 PPO =   $3500 annual deductible
Health Net SmartChoice 50 PPO =   $5000 annual deductible

Remember, you get 100% coverage after the deductible is met. It's that simple!

Accident Plan Add-on
We recommend you pair this plan with our preferred VBA accident plan to help offset any out of pocket expenses you have due to an unexpected accident. This could save you thousands in the event of an accident.

Option 2) Blue Cross RightPlan 40 PPO.
(maternity not covered)

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The Blue Cross RightPlan 40 PPO has NO DEDUCTIBLE. With this plan you pay a flat $40 doctor visit copay. For labs, x-rays and hospitalization, you pay 40% of the discounted fees and Blue Cross pays 60%. It's that simple! Keep in mind that this plan is an individual plan only, meaning couples and families wanting this plan must each enroll separately.

With the RightPlan 40 you have a choice of (1) no prescription drug coverage, (2) generic drug coverage only or (3) comprehensive drug coverage (brand name drugs included). This allows you to adjust your premium depending on your prescription drug requirements.

Option 3) Blue Cross Tonik Plan.
(maternity not covered)

The Blue Cross Tonik Plan is a PPO plan (3 plans to choose from) designed for young people who want a simplified plan that is affordable too.

If you ride a skateboard or snow board, or there is a good chance that this plan is for you. Not only does the plan offer a low copay for doctor visits, and includes dental, but it also allows you emergency room visits for a flat $100 copay. Also, for hospitalization, once you meet your deductible, it gives you 100% coverage for the remaining calendar year.

There is a separate site to run Tonik quotes, where you can also apply online. Click below to see if Tonik is for you.

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I want a comprehensive PPO plan. I don't mind paying a little extra for a comprehensive plan. I don't like being "nickeled and dimed" every time I go to the doctor. Also, I want the freedom of a PPO plan, so an HMO is out of the question.

Our recommendation...

Our favorite
Option 1) PacifiCare SignatureOptions 70-50/1000 PPO
(available with and without maternity coverage)

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This is one of the best comprehensive PPO plans available! The best part about this plan is that unlike most PPO plans, they waive the deductible for labs, x-rays and, of course doctor's visits. Most all PPO's require you to pay a steep deductible before they pay for any labs and x-rays, however this plan immediately starts paying for their share of those often used services, which is 70% (their share) ... and you pay only 30% for those services.

Option 2) Health Net FirstChoice PPO
(this plan does include maternity coverage)

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This plan is very unique. Health Net pays for the first $500 worth of your out of pocket expenses (per person), each calendar year. Therefore if you do have a a few labs or x-rays, or even a minor emergency room visit, the first $500 of those services are paid for by Health Net.

After you exhaust the $500, you have a $3000 deductible. For healthy families and individuals, the $500 first dollar benefit usually covers most services, if not all of your out of pocket expenses. But in the event of a year requiring many services, your annual max-out-of-pocket outlay is capped at $3,750. This plan covers generic prescription drugs for a $15 copay (no brand name coverage).

Option 3) Blue Cross PPO Share 1500
(maternity is covered on this plan)

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This is a very traditional PPO plan from Blue Cross. Many of the companies are getting away from covering maternity and brand name prescription drug coverage, but this one is a comprehensive plan covering full prescription drugs and maternity too.

You can also take a look at the Blue Cross PPO Share 2500, PPO Share 1000 and PPO Share 500 plans too (the name corresponds to the plan deductible). Depending on which one you go with, your deductible and annual max-out-of-pocket amounts will vary. We happen to like the $1500 plan because the deductible and annual-max-out-of-pocket outlay (worst case scenario) are a little more reasonable on this plan, yet the premium is still reasonable.

I like HMO's. I want to know that when I go to the doctor (or when my family goes), I can pay my basic office visit copay and be done with it.

Our recommendation...

Our favorite
Option 1) PacifiCare SignatureValue 35/70 HMO
(This plan does include maternity coverage)

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The name PacifiCare is synonymous with HMO. Their HMO network is very extensive and the price of this HMO is very affordable in comparison with some of the other carriers. Clients tend to stay on this plan for a long time.

This plan has no deductible and the prescription drug coverage is the best in the industry. Generic drugs are covered in full with a $20 copay and brand name prescription drugs are covered in full with a $35 copay (no brand name deductible applies... most other companies require a separate brand name deductible).

Option 2) Blue Cross Select HMO
(This plan does include maternity coverage)

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This plan is one of the best value HMOs available, however with a big caveat... The Blue Cross HMO network for the Select HMO plan is smaller than the regular Blue Cross HMO network. We recommend that before you go with this plan you investigate how many providers are in your area, including primary care physicians, hospitals and specialists. If you live in the Los Angeles area, you have many choices, but outside of LA, we recommend you check out the available providers.

Here is a link to view Blue Cross Select HMO providers in your area:
View doctors and provides in your area: (select the Blue Cross Select HMO network)

Option 3) Blue Cross Traditional HMO
(This plan does include maternity coverage)

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This is the cream of the crop HMO. It features no deductible, a low $10 office visit copay, and 100% coverage for inpatient hospitalization. Prescription drugs are $10 for generic and $30 for brand name (plus a $250 annual brand name deductible). The premium on this plan is higher due to the comprehensive coverage and low ongoing out of pocket costs.

This plan also has one of the largest HMO provider networks available, statewide.

Here is a link to view HMO providers in your area:
View doctors and provides in your area: (select Blue Cross HMO network)

I'm looking for an HSA plan. I hate paying all of this money to the insurance company each month, when I rarely ever go. I'll save my money in an HSA bank account and when I need to go, I'll just pay from that account (tax free) and get a tax advantage on the money that I set aside each year. But if I have a major accident or illness, I want the security of a major medical plan to pay my bills.

Besides... any money I don't use over the years will go toward my retirement, similar to an IRA.

Our recommendation...

For Singles
Option 1a) Blue Shield - Shield Spectrum Savings 2400

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For Families
Option 1b) Blue Shield - Shield Spectrum Savings 4800

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The Blue Shield HSA plans have low deductibles. Also the family plan Shield Spectrum Savings 4800 has a single deductible for the entire family, meaning once the combined out of pocket expenses of all family members reaches $4800, the deductible is met and all expenses after that are covered by Blue Shield at the 70% level for most services.

I'm looking for a senior Part B Medicare supplemental plan. I want something to cover my excess charges that my Part A Medicare plan does not currently cover. I would also like to have some prescription drug coverage too ...

Our recommendation...

Option 1) Blue Cross Senior Classic F Plan

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Now that the new Medicare Part D coverage is coming, it is no longer necessary to get a plan that covers prescription drugs. Therefore the plan that we recommend is the Blue Cross Senior Classic F Plan. This plan will work well with the new Medicare Part D prescription drug plan.

Now that you have a better idea of California health insurance plans to investigate, please click below to start your instant quotes session...

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If you have any additional questions, please don't hesitate to call.

Call us toll-free at (800) 610-6418

Bill Lorenz
California Insurance Lic. 0D61899