Health Insurance 101 with JC Lewis Insurance Services

If you are a young adult living in Northern California and between the ages of 18-25, you are very likely looking to get your own insurance for the first time.

There are several reasons why this might happen.

If you do not have your parents’ insurance, or if they are not, you may be looking to get your own coverage. However, keep in mind that you can legally stay on your parent’s health insurance until age 26. This was a change implemented by the Affordable Care Act when it became effective in March 2010.

Another scenario could simply be that you chose to buy your health insurance either because your employer doesn’t offer it, or you don’t want what your company offers.

By the way, you should also know that companies with 50 or more employees are required to offer affordable healthcare coverage options to employees. and State Sanitation Market, Covered California, pointing toAnd the

“Small business owners with fewer than 50 full-time employees are not required to offer health care coverage for their employees. However, you should know that if a small business with fewer than 50 full-time employees offers coverage, that coverage must comply with the requirements of the ACA. “.

And third, you are very likely to be self-employed either as an independent contractor or as a young entrepreneur and business owner. In this case, you will likely have to find your own health plan.

Regardless of whether you stay committed to your parents’ policy, follow the plan offered by your employer, or choose to find your own health insurance plan, you should still get coverage.

Study health insurance in California

Since 2020, state law requires Californians to have health insurance. This law is referred to as “individual authorization” because all individuals in California are required to be covered by health insurance.

As a healthy person, perhaps still unmarried, you may consider medical insurance unnecessary. However, no matter how healthy and fit you are, things happen. Much like car insurance, while you don’t use it every day, when you have an accident, you definitely want it.

Likewise, if you are going to stumble down some stairs and break your arm, you will be happy to have health insurance. That’s largely because it’s even the basics treatment cost A broken arm can be over $6000 without insurance. This is for a simple break. If you have more complex injuries, you may be charged more.

That’s because everything associated with Medicare costs money—and usually a large portion of it.

For example, any trips in an ambulance, medications given, medical equipment and supplies used, x-rays and other imaging services, as well as doctor and nurse time, all add up very quickly. And if you have to stay in the hospital even for a short period of time, the costs increase even faster.

In fact, the Average cost of hospital stay It can reach up to $10,000 a day.

Along with an affordable health insurance plan and policy, it would be wise to get vision insurance, dental insurance, and comprehensive prescription drug coverage as well.

The Three Most Popular Types of Health Insurance Plan

Strictly speaking, there are more than six different types of health insurance “plans” from the Marketplace available in California, including what’s known as High Deductible Health Plan, or HDHP, which is a health insurance policy with a lower monthly premium and a higher deductible. These are more common among younger members and are often paired with health savings accounts or HSAs.

Marketplace health insurance plans are designed to meet diverse needs. However, the three most common types of plans are PPO, HMO, and EPO plans. Here is a brief explanation of each:

PPO, or Preferred Provider Organization, It is a type of health plan that allows you to pay less if you use providers in the plan’s network. You can use doctors, hospitals, and out-of-network providers without a referral for an additional cost. Members enjoy an annual discount that they will be required to meet before coverage begins for their medical bills, along with a monthly premium. In addition, there is also a co-payment for certain services.

a Health Maintenance Organization, or HMO, It is a type of health insurance plan that usually limits coverage to care from physicians who work or contract with the HMO. It generally does not cover out-of-network care except in emergency situations. The HMO may require you to live or work in its service area to be eligible for coverage. On the other hand, members usually have less money.

At the HMO, visits to specialists require a referral from the primary care provider or primary care provider. Although HMO members typically have co-payments for services, they may not be required to pay a discounted amount before their coverage begins.

EPO, or Exclusive Provider Organization Plans are similar to HMO in that services are covered only if you use doctors, specialists, or hospitals in the plan’s network except for emergencies. There is usually a lower premium than with a PPO offered by the insurance company itself. With the European Patent Office (EPO), you may have limited options for your healthcare providers although it is likely more so with HMO.


Talking about health insurance money 101

All health insurance includes costs. While these costs can be significantly reduced with a subsidized health plan purchased through the state’s marketplace, Covered California, there will always be costs, though.

Below is a basic overview of the overhead costs associated with health insurance coverage.

What are health insurance premiums?

This is the monthly cost you will pay for your health insurance regardless of whether you use your coverage or not. While this is the primary cost that most consumers tend to consider when choosing a plan, along with a premium, you usually have to pay other costs such as an annual deductible, co-pays, and coinsurance.

If you qualify for a Marketplace health plan, you may be able to lower your premium costs with a tax credit.

What are the deductions in health insurance?

This is the amount you pay for covered health care services before your insurance plan starts paying. If your plan is a $2,500 deductible, for example, you’ll pay the first $2,500 of covered services yourself. This is quite similar to the deductible you may have on your car insurance.

After you pay the deductible, you only pay a co-payment or co-insurance for covered services and your insurance company pays the rest. Generally, plans with lower monthly premiums have higher deductibles, while health plans with higher monthly premiums have lower deductibles.

What is a joint payment for health insurance?

Co-payments, or contributions, are a fixed amount ($15 or $20, for example) that you have to pay for Covered Health care service after payment of the deductible.

An example would be a standard office visit. If the allowable cost of your health insurance plan for a doctor’s office visit is $150, you joint payment A visit to the doctor may be only $20. If you haven’t met your deductible yet, you’ll pay the full $100 visit allowance. However, if you have paid the deductible, you will only pay $20, often at the time of the visit.

Health plans with lower monthly premiums usually have higher co-pays. Plans with higher monthly premiums usually have lower combined premiums.

What is co-insurance?

The percentage of covered health care costs that you may be required to pay after paying the deductible, often 20 percent in most cases.

according to website At,

“Not all medical services are subject to coinsurance, and not all Obamacare plans come with coinsurance requirements. Generally, higher-expensive or higher-order mineral-level plans (such as platinum plans) may not require a coinsurance payment. Coin insurance should not be confused with and another form of cost sharing such as subscriptions or discounts.”

How do you get health insurance?How do you get health insurance?

The good news is that getting health insurance in California is actually very easy.

One popular method is simply to apply for health insurance from The Marketplace, also known as Covered California. The Health Care Marketplace, also known as The Health Insurance Marketplace or simply The Marketplace, was created under the Affordable Care Act as a way to expand health insurance coverage to uninsured Americans.

Several states offer their own markets, including California, which can be found at

Through the Covered California program, individuals can apply for health insurance through what is known as open enrollment. This is a window of time in which employees have to choose or change their coverage for the next year. For example, open enrollment for 2023 starts on November 1, 2022 to get health insurance from the market.

If you are currently unemployed, you may be wondering how to get health insurance without a job?

The good news is that this is a real possibility with Covered California. as their website Statespeople who are unemployed may be able to get an affordable health plan through the state market based on their family size and income.

Another option that qualifies for free or low-cost coverage is through Medi-Cal.

Get health insurance with the help of JC LEWIS Insurance

At JC Lewis Insurance, we want to be your insurance partner and offer only quality health insurance plans from leading health insurance companies licensed to do business in California.

We are a family owned and operated health insurance agency located in Sonoma County, California. We specialize in finding and managing medical insurance plans not only for individuals, but families and small businesses as well, and we are authorized and approved by every insurance company we represent.

Finding the right health insurance plan in California can be difficult and there are many options to choose from. For example, if your employer does not offer health benefits, the individual plan It may be the best option for you.

We at JC Lewis Insurance understand that when considering different health insurance options, there are likely to be many questions and concerns. We invite you to bring Questions about health coverage Insurance is ours and you can rest assured that JC Lewis Insurance Services will help you find the right solutions for your health insurance needs.

So, Contact us today For more information or request a quote Online.


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