Individual & Family Health Insurance

If you cannot get health insurance from your employer or through government medical programs, you can purchase Health Insurance for yourself and/or your family. Health Insurance is available either directly with the health insurance carriers or through Covered California.


What is Individual Health Insurance?


This is a health plan purchased directly by you for yourself and/or family and not through your employer or the government.

Because of the Affordable Care Act (ACA), consumers cannot be denied enrollment due to pre-existing or chronic health issues.

Generally benefits and cost-sharing fall under the metal tiers: Bronze, Silver, Gold, and Platinum. These plans cover 10 minimum essential benefits:


  1. Ambulatory Services
  2. Emergency Services
  3. Hospitalization
  4. Pregnancy, Maternity, and Newborn Care
  5. Mental Health and Substance Use Disorder Services
  6. Rehabilitative Services
  7. Laboratory Services
  8. Preventative Services
  9. Pediatric Services
  10. Prescription Drugs


Plans fall under different types of coverage:


Health Maintenance Organizations (HMO). Under this type of plan, consumers are assigned a Primary Care Provider (PCP) and will need a referral to see a Specialist within your network.


Preferred Provider Organization (PPO). Consumers are able to see all providers within their network without a referral. These types of plans also include out-of-network coverage for some services.


High Deductible Health Plans (HDHP). These are plans with no first dollar coverage. You have to set money aside to pay for these medical and pharmacy costs. You can set up a Health Savings Account (HSA) to use the unique tax-advantages to cover a large portion of your deductible.


Minimum/Catastrophic Coverage Plans. This type of plan has a high deductible and high out-of-pocket cost and is only available to consumers under 30 years old. It will typically cover three PCP care visits per year without a copay. These plans do not qualify for an HSA account.


When Can I Enroll in Individual Health Insurance?


Open Enrollment Period: Takes places November 1st through January 31st. Anyone can sign up or make changes to their health insurance.


Special Enrollment Period: Takes place after Open Enrollment. You must have a Qualifying Life Event (QLE) to be able to get health insurance during this period. These

are some of the most common Qualifying Life Events. For the full list please contact us.


  • Losing group health insurance or Medi-Cal
  • Moving into a new service area
  • Having a baby
  • Getting married
  • Gaining lawful presence


The Importance of Obtaining Health Insurance


The primary reason for having health insurance is gaining access to care and the security of knowing that if you have a catastrophic illness or injury you will not be financially burdened or even need to file for bankruptcy.


Both adults and children are more likely to receive preventative care, early diagnosis, mental health care, better management of chronic conditions, and prescription medications.


You’ll also want to avoid the penalty for not having health insurance which California imposed in 2020.

Office

2725 E Pacific Coast Hwy.
Suite #101

Signal Hill, CA 90755