Understanding and Comparing Health Insurance in California

itself. If the doctor runs labs, performs procedures, or does other services in addition to the consultation, these charges are handled in the third section and will be in addition to the copay or co-insurance.

The office consultation is one of the key items when looking at your California health insurance quote for Individual Family or Small Group insurance. You will typically see “” or “30%” in the results.

A quick note. With HSA qualified high deductible plans, the office visit consultation is subject to the main deductible. This means you must meet the deductible before you get a copay or co-insurance benefit. You will get negotiated rates for seeing an in-network provider even if the benefit is subject to the deductible. For example, in the case above, you would pay the as part of your deductible. Some plans do not cover office visits at all. They tend to be the least expensive hospital or catastrophic coverage plans.

2. Prescription coverage and California health insurance. With most plans, prescription coverage is broken out separately from the main deductible in the form of copays. Almost all plans on the market today distinguish between Generic and Brand name.

Insurance companies have a Formulary, or list of drugs they deem to be effective and cost-effective.

The lower-priced drugs are Generic and typically you have a smaller copay (around on average) which is not