In the upcoming months, next few years, and time to follow, health insurance in California is set for some staggering changes. Sweeping transformation brought on by legislative amendments and court decisions means big changes, mainly by introducing a new marketplace concept in California that will be available in 2014. Under law, essential health benefits must be provided, including maternity care, emergency, certain mental health needs, and specific hospitalization services. Beyond these, more complex considerations come into play when deciding what levels of coverage suit specific needs. One of the first issues to come up is cost associated to the new plan. First and foremost, individuals will now be provided assistance in various ways if essential health care is cost prohibitive and out of reach. Mainly, tax crediting, cost sharing based on household income, and expansion of the Medi-Cal program. Covering the basic health care needs, the market then becomes open for individuals and families to explore what health care insurance options best suit their lifestyle and budget.
Starting in 2014, health insurance in California will be offered from 4 federally designed basic levels of coverage. Costs will primarily be determined on the exchange depending on how many people in a household require coverage, their ages, and annual household income. Platinum and gold coverage are the highest levels and most comprehensive and expensive options for coverage. This translates to less copays across the board and a less up of an upfront or out of pocket expense when gaining most medical services. The silver plan attempts to strike the middle ground balance between affordability and flexibility. There is also a lower cost sharing option available on a sliding scale within the silver plan. The bronze plan is offered for individuals looking for basic coverage just beyond basic care and catastrophic coverage will be available to those 30 years of age or younger.
In light of these changes, individuals and families are faced with important decisions to help secure a healthful future. Determining budget, balanced with needs and values will play a crucial role in the factors leading up to the decision regarding what level to choose. Attempting to strike a balance with affordability and availability, careful assessment of what each plans includes and extends to cover will also be crucial. Assistance is already, and will be widely available to help understand the different levels available and what will best balance these factors. As technology charges forward, information regarding health insurance in California will also be easier to access and understand. Online tools such as calculators, web-based assistance programs, and organizations designed to provide the best and most accurate information will also be a mouseclick away. Staying informed, having questions answered early, and knowing the facts is the best way to ensure a right choice is made, especially when considering the introduction of window enrollment periods. Whether its platinum, gold, silver, or bronze, becoming the best advocate for yourself and family through information and knowledge will serve as the best tool while California continues to reshape health insurance programs.