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Which company to choose?
There are only 6 health insurance companies in our area that write Individual and Family Health Insurance. Health Net and Blue Shield are the only remaining companies that offer a PPO (Preferred Provider Organization). Oscar is the newest entry into the Southern California health insurance market. Founded in 2012, Oscar is a high tech health company that has gained a very good reputation lately.
Health Net Enhanced Care PPO is the least expensive PPO on the market and their Community Care HMO (Health Maintenance Organization) is the least expensive HMO. The Health Net Community Care Silver HMO is the best bang for the buck. Be aware that there is a reason that these two plans are so inexpensive – their provider network is not as extensive as, for instance, Blue Shield. Oscar uses the EPO (Exclusive Provider Organization) format, a hybrid of HMO and PPO.
Define PPO, HMO and EPO:
PPO: Preferred Provider Organization gives the broadest choice of providers. Choose any doctor or specialist within their provider network and go. No need for pre-authorization for most visits. HMO: Health Maintenance Organization is the most restrictive form of provider network. You must pre-choose a primary care physician who must pre-authorize diagnosis and treatment and determine what specialist or hosptial you see. You must have pre-authorization from your primary care physician before you can go. EPO: Exclusive Provider Organizations is a hybrid of PPO and HMO, with broader choice of providers than HMO and more restrictive than PPO. These are general descriptions and you should consult each company separately as to specifics.
Twenty years ago there were many health insurance companies in California writing individual health insurance policies. They had a wide variety of rates, plans and providers. Now there are only a half dozen companies offering individual and family health insurance policies in Southern California and almost all of them are HMO’s or a variation of HMO. The rates, coverage and providers are very similar, one to the other, among the few remaining companies. Obamacare has greatly reduced competition in the health insurance industry which, alone, greatly increases insurance costs.
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BUT…You can no longer apply for health insurance any old time you want!