by 🗓️The Renewal Season for 2024 just started!
Prepare for a shift as Oscar Health exits the California insurance market in 2024. Navigate the transition with confidence—discover your health insurance choices and essential steps for you and your family in the upcoming year.
Step 1 🪜: Are you eligible for subsidies over Covered California 💸
Please review your adjusted gross income (AGI) on your tax return for 2022 (line item 11) and project your income for 2024. If you earn foreign income, tax-exempt income, or non-taxable social security, you need to add this income to your adjusted gross income to get the MAGI (modified adjusted gross income). Many Californians will qualify for subsidies in 2025. Only Californians over the 600% Federal Poverty Level for a family of 4 is $ 180,000. Single households under $87,000 will be better off buying outside of Covered California, directly with the insurance carriers.
Step 2 🪜🪜; Decide if you prefer a more affordable HMO or if you need a PPO to access a wide network.
In weighing your options, you can opt for the economical HMOs, where a primary doctor guides your referrals within their group. Alternatively, there’s the pricier PPO, offering self-referral but with a substantial increase in your health insurance premium.
1. Affordable HMO Plans 💸
- Choose a primary doctor🩺
- Your primary doctor will refer you to specialists within the medical group.
Options:
- LA Care: Offers the UCLA system and, depending on your zip code, the Providence system, Optum, Prospect IPA, PIH, Children’s Hospital, and many more. Rate: lowest premium increase in 2024 of 6.1%
- Anthem: While UCLA and Cedars are not available, Anthem offers the Providence System, Axminster, Allied IPA, and others. Premium increase of 10.9% in 2024
- Blue Shield: Provides the HMO Trio, a solid primary care doctor network with the Providence System (St. John Hospital, St. Joseph, Providence Cedars Tarzana, Access Medical Group, Allied Pacific-UCLA, and Cedars are not in the network). Premium increase of 15% (ouch!) in 2024
- Kaiser: Provides an HMO inside the Kaiser System and includes access to Kaiser hospitals. Premium increase of approximately 7.4%
- Health Net and Molina: very limited network on the Westside of LA (Health Net increased 8.4%, Molina 8.1%)
- If you are interested in an HMO— please advise your primary doctor and preferred network so that we at Solid Health Insurance Services can send you the health plans that best fit your needs.
2. Freedom of Choice with PPO Plans 🚀
- Enjoy the flexibility to choose your preferred doctors and hospital!
Options:
- Blue Shield PPO: Offers an extensive network with self-access to many UCLA, Cedars Sinai, and Providence doctors. Please note that premiums are relatively higher. Premium Increase of 15.0%! Ouch!
- Health Net PPO: Not contracted with UCLA or Cedars Sinai, but it allows self-referral to the Providence system and other providers. Premium increase of 8.4%.
We understand these decisions can be complex and that losing Oscar, which offered you flexibility and a lower premium, is difficult. Feel free to 📞contact us at Solid Health Insurance Services. In doing so, we can guide you in selecting a health plan, whether through Covered California or directly with insurance carriers. Our goal is to find a suitable option that aligns with your medical needs and budget.
