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Self-help guide to Individual Medical health insurance

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The modern Covered California health care insurance marketplace offers a number of affordable health plans that you should pick from. Regardless if you are self-employed, or trying to find coverage in addition to what your employer currently offers, there is a plan which will likely fit the bill. Federal regulations require that health plans operating within the Affordable Care Act (ACA) meet certain access requirements. In California, those requirements include timely entry to healthcare providers, along with geographic access standards.


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Here's a general self-help guide to individual medical health insurance that you could make reference to when selecting a plan. And do not forget these important dates regarding open enrollment for 2016.

Provider Networks

When choosing a medical insurance plan, you should verify the plan's provider network of doctors, hospitals, medical professionals, therapists, and other health care providers. It's essential to understand what is not covered too. Understanding your plan's provider network helps you save money, receive better care, avoid unexpected fees and costs, and be happier using the care you get.

Out-of-Network Care

You are not on a health care providers within your network, but when you choose to use one away from your network, health insurance will take care of less resulting in a higher out-of-pocket cost to suit your needs, except in the situation of emergencies.

Provider No more in Network

Should your physician leaves your network, you may generally are looking for a fresh doctor inside the network, and most plans will help you by doing this. Usually, a medical plan's continuity of care policy allows the patient to remain care using a doctor no more inside the network for any certain time frame at the lower cost-sharing rate.

Cost-Sharing Requirements

Each plan has different cost-sharing requirements. Typically, your current share of costs is really a mix of the premiums you pay plus some other co-payments, co-insurance or deductibles that you can are financially responsible.

How to Find a Doctor

Generally, the program you choose may listing of doctors who accept your insurance. The Medical Board of California offers some great tips on picking a doctor:

 Ask friends, family or co-workers about physicians they like.
 Ask your county medical society or association for names of physicians locally.
 Once you've certain names, call and get if the doctor is accepting new patients and whether or not they accept your insurance policy.
 Check with all the Medical Board to make sure that health related conditions carries a current California license.
 Meet together with the physician and consider creating a physical done to see whether this can be the doctor for you personally you.