Health Insurance Companies in California Guide

California has a complex health insurance landscape, with numerous companies offering a range of plans.

There are several major health insurance companies in California, including Blue Shield of California, Kaiser Permanente, and UnitedHealthcare.

These companies offer a variety of plans, including HMOs, PPOs, and EPOs, each with its own set of benefits and drawbacks.

Blue Shield of California, for example, offers a range of plans, including the Blue Shield PPO and the Blue Shield HMO, which have different levels of coverage and out-of-pocket costs.

Valley Health Plan offers several plan options for California residents, including platinum, gold, silver, bronze, and minimum coverage plans.

Valley Health Plan was founded in 1985 and offers health plans for employer groups, Covered CA, and individuals and families.

Their mission is to provide the most affordable managed care products available in the marketplace to purchasers and consumers across a wide spectrum.

Health Net plans come with several benefits, including a nurse advice line, health coaching program, disease management, and more.

Health Net also offers free in-home health assessments, which can be a valuable resource for those who need extra support with their health.

If you see a doctor less often, you may want to consider higher deductibles but lower monthly premiums, or vice versa if you see a doctor more often.

Chinese Community Health Plan is a San Francisco-based health plan that was founded in 1986. It serves over 21,000 members and has a network of over 1,700 doctors.

Their metal tier system includes bronze, silver, gold, and platinum plans, with out-of-pocket limits ranging from $3,350 to $7,900 for individual plans and $6,700 to $15,800 for family plans.

Most plans include low copays on pediatric vision and dental, prescription drug coverage, emergency health coverage, and outpatient services. Benefits vary based on the plan you choose.

Here are the out-of-pocket limits for Chinese Community Health Plan:

CCHP also offers Medicare and employer plans, providing a range of options for different needs and circumstances.

Medi-Cal is California's Medicaid program, which is available to low-income families and individuals. It's a crucial resource for many Californians.

As of 2019, Medi-Cal covers more than 12 million Californians, a significant increase from 2014 when 11.4% of California residents, or 1,003,700 people, enrolled in the program. Medi-Cal's expansion has played a big role in reducing California's overall uninsured rate.

In 2013, 17.2% of California's residents didn't have health insurance. After California expanded its Medicaid program in 2014, the state's uninsured rate dropped 36.6% by 2019.

Medi-Cal eligibility is based on income levels. Here are the financial requirements for Medi-Cal:

To find out more about Medi-Cal eligibility and requirements, check out the resource from Covered California.

Oscar Health Plan of California offers a unique set of benefits to its customers, including unlimited 24/7 calls with doctors. Oscar's top three plans in L.A. are the Classic Silver, the Saver Bronze, and the Classic Bronze.

Plan premiums range from $265 to $428, with deductibles ranging from $2,500 to $6,300. This can be a cost-effective option for those who don't need to see a doctor frequently.

Oscar was founded in 2012, with a mission to "be a health insurance company centered around the patient." Their focus on patient-centered care is reflected in the services they offer, such as money for step tracking and over-the-phone prescriptions.

Their network covers four of the five top hospitals in L.A., making it a convenient option for those in the area. With over 700 employees and 250,000 members, Oscar has established itself as a major player in the California health insurance market.

If you're a small business owner in California, you're in luck because there are health insurance options available for groups with 2 to 50 or 100 employees, depending on your state.

These plans offer a full range of health insurance options, so you can choose the one that best fits your business needs.

You can choose from a variety of medical, pharmacy, dental, vision, life, and disability plans, giving you flexibility and control over your business's health insurance.

Translation and alternate format services are also available to you on a standing basis, free of charge, which can be a big help if you have employees with special needs.

Just call (800) 578-2142 (TTY: 711) to get started.

Health insurance plans in California are organized into metal categories: bronze, silver, gold, and platinum. The higher the plan, the more it costs.

A bronze plan costs an average of $314 per month for a 40-year-old California resident, while a gold plan costs $443 per month. That's a 41 percent increase in premiums.

The metal categories differ in the percentage of medical costs they cover. Bronze plans cover about 60 percent, while gold plans cover 80 percent. It's worth paying more for a higher-tier plan if you need better coverage.

You may qualify for a catastrophic plan, which is generally reserved for those under 30 or with certain exemptions. These plans come with a high deductible of $8,150 as of 2020.

Here's a breakdown of the monthly costs for different metal categories:

In California, you have many options for health insurance. You can get coverage through Covered California, Medi-Cal, or directly from an insurance company.

Covered California offers a range of plans, with 12 insurers participating in the marketplace for 2025. These insurers will offer plans that can be subsidized based on your income.

You can enroll in a Covered California plan through their website, by phone, or with the help of an insurance agent or certified enrollment counselor. You can also receive assistance through their "help on demand" program.

If you're eligible, you can receive income-based subsidies that can reduce your monthly premium. As of early 2024, nearly nine out of ten Covered California enrollees were receiving premium subsidies, with an average subsidy of $523/month.

In addition to premium subsidies, you may also be eligible for federal cost-sharing reductions (CSR) if your household income is below 250% of the federal poverty level. CSR benefits can reduce your deductible and other out-of-pocket expenses.

California is also supplementing federal CSR benefits with additional state-funded cost-sharing subsidies. Eligible Silver-plan enrollees have $0 deductibles and lower costs for other out-of-pocket expenses.

Here are the key factors to consider when choosing a health insurance plan in California:

Keep in mind that California does not allow short-term health insurance policies, so you'll need to choose from one of these options.

Twelve insurers will offer plans through Covered California for 2025, the same number as in 2024.

If you're shopping for health insurance in California, you'll have a choice of 12 insurers to consider for next year.

Oscar Health Plan of California left the California Marketplace at the end of 2023, but another insurer, Inland Empire Health Plan, joined for 2024.

Inland Empire Health Plan is a newcomer to the California Marketplace for 2024.

The number of insurers offering plans in California's Marketplace has remained the same for two years in a row, providing stability for consumers.

In California, you can enroll in a Covered California Marketplace plan through Covered California's online platform, where you can compare plans and determine if you're eligible for financial assistance. You can also reach out to a certified enrollment counselor or an insurance agent for help.

The open enrollment period in California is longer than in most other states, running from November 1 to January 31, with an extension to February 9, 2024, for 2024 coverage. If you enroll between January 1 and January 31, your coverage will take effect on February 1.

To enroll in a plan through Covered California, you can visit their website, call their call center at 1-800-300-1506, or use their "help on demand" program to receive a call from a certified enrollment assister.

Twelve insurers will offer plans through Covered California for 2025, the same number as in 2024. This is unchanged from 2024, when the same 12 insurers offered coverage.

You can find affordable health insurance in California by enrolling in a plan through Covered California, where you may be eligible for income-based subsidies that can reduce your monthly premium. Nearly nine out of ten Covered California enrollees were receiving premium subsidies as of early 2024.

Here are some key details about Covered California's subsidies:

Covered California also offers federal cost-sharing reductions (CSR) to applicants with household incomes below 250% of the federal poverty level, which can reduce your deductible and other out-of-pocket expenses. California is supplementing these federal CSR benefits with additional state-funded cost-sharing subsidies.

Insurance rates in California have been a topic of discussion in recent years. The overall average rate increase for 2025 is 7.7%, which is slightly lower than the initial 7.9% filed by insurers.

Most enrollees in Covered California don't pay full price for their plans, as nearly nine out of ten receive premium subsidies to offset their monthly payments. The subsidy amount varies for each enrollee and changes each year based on their household income and the cost of the second-lowest-cost Silver plan.

The approved rate changes for 2025 vary among insurers, with Aetna CVS Health experiencing a 15.4% increase and Inland Empire Health Plan seeing a 1.8% decrease. Here's a breakdown of the approved rate changes for each insurer:

Over the years, average full-price premiums have fluctuated in California's individual/family market. Here's a look at the changes: 2015 saw a 4.2% increase, followed by 4% in 2016, and then a significant 13.2% increase in 2017.

Residents of California spend an average of $7,549 per year in health care expenditures, which is only a little below the national average.

Health insurance costs in California vary based on individual habits. Factors such as age and zip code can impact premium changes.

The cost of the second-lowest-cost Silver plan relative to the enrollee's household income determines the subsidy amount, which changes each year. This means that the subsidy amount is different for each enrollee.

Full-price (unsubsidized) premium changes depend on the specific plan, as well as the enrollee's age and zip code.

Here's a look at the average rate changes for 2025 for the insurers that offer plans through Covered California:

The overall average rate increase for 2025 is 7.7%, which is slightly lower than the 7.9% average rate increase that insurers initially filed in California.

In California, a significant number of people rely on the state's Marketplace for health insurance. 1,784,653 people enrolled in 2024 plans through Covered California during open enrollment.

Covered California has seen a consistent trend in enrollment numbers over the years. The highest enrollment numbers were reported in 2024.

A total of 1,784,653 people were insured through California's Marketplace in 2024. This is a notable increase from previous years.

The lowest enrollment number was reported in 2014, with 1,163,645 people enrolling in plans through Covered California.

If you're a California resident looking for health insurance, you're in luck because there are several resources available to you.

Covered California is the state's Marketplace/exchange, where you can enroll in individual/family health plans and receive income-based subsidies, and also enroll in Medi-Cal.

You can contact Covered California directly at 800-300-1506 for assistance.

The California Department of Health Care Services administers Medi-Cal and various other health care programs.

The California Department of Managed Health Care (DMHC) regulates the vast majority of California's commercial health plans and can assist consumers and businesses with insurance-related questions and concerns.

If you have a complaint or concern about a health plan regulated by the DMHC, it will be forwarded to the California Department of Insurance.

The California Health Insurance Counseling and Advocacy Program (HICAP) provides information and assistance specifically for California Medicare beneficiaries and their caregivers.

In California, insurance companies offer a range of plans to fit different budgets and needs.

Kaiser Permanente, for example, is a popular choice with over 8 million members statewide.

Blue Shield of California has a network of over 36,000 providers, making it a convenient option for those with existing doctors.

Many insurance companies in California offer plans with varying levels of coverage, including bronze, silver, gold, and platinum plans.

Anthem BlueCross of California offers free preventive care to its members. This is a great perk for those who want to stay healthy and catch any potential issues before they become major problems.

The company has a variety of plans to choose from, including individual and family plans, minimum coverage plans, Medicaid, and Covered CA. This means you can pick the level of coverage that's right for you and your budget.

Anthem BlueCross also offers online tools to help you manage your health, such as a 24/7 nurse advice line and personalized coaching. These resources can be super helpful in staying on top of your health.

The price of your plan will depend on how often you plan on seeing a doctor and the level of coverage you need. This is a good thing to keep in mind when choosing a plan, as it will help you make an informed decision.

Anthem BlueCross' mission is to deliver better care to its members, provide greater value to its customers, and help improve the health of its communities. This mission is at the heart of everything the company does, and it shows in the services they offer.

Blue Shield has been around since 1938, making it a long-standing option for Californians.

The company has a significant presence, with 6,800 employees serving over four million members.

Blue Shield offers a range of medical plans, including bronze, silver, gold, platinum, and minimum coverage options.

Depending on the plan, members can expect different benefits, deductibles, and out-of-pocket costs.

Most Blue Shield members (56 percent) purchase individual and family plans through Covered CA.

Blue Shield prides itself on giving back to the community, with employees raising over $400,000 for local nonprofit organizations in 2014.

Some of the member benefits include a 24/7 nurse help line, care programs, gym discounts, and wellness programs.

What types of insurance plans are available? There are various types of insurance plans, including health, life, home, auto, and disability insurance.

Do I need to have health insurance? If you're employed, your employer may offer health insurance as a benefit, but it's not mandatory to have it.

Can I customize my insurance plan? Yes, you can often choose from different levels of coverage, deductibles, and premium costs to suit your needs.

How do I choose the right insurance company? Research the company's ratings, coverage options, and customer service to make an informed decision.

What is a deductible, and how does it work? A deductible is the amount you pay out-of-pocket before your insurance coverage kicks in, and it can range from $500 to $5,000 or more.

Can I switch insurance companies? Yes, you can switch insurance companies at any time, but be aware that you may face penalties or fees for canceling your policy early.

Looking for a reliable health insurance agency in California? Let's take a closer look at the top agencies in the state.

J.C. Lewis Insurance Services is one of the top-rated agencies in California, with an address at 100 E Street #205, California, CA 95404.

Marina Amezcua is another top agency, with an office located at 4940 N Long Beach Blvd Suite C -1St Floor, California, CA 90805.

Health Insurance Exchange Online is a well-known agency with a presence in California, located at 6025 N Palm Ave, California, CA 93704.

Health for California is a reputable agency with an office at 4000 Montgomery Dr Ste D7, California, CA 95405.

My Socal Insurance Solutions is a top agency with a location at 26565 Agoura Road, Suite 200, California, CA 91302.

California Health Quote Insurance is a trusted agency that has been in business since 1986, offering a range of insurance plans to Californians.

Here are the top agencies in California, summarized in a table: