Health Insurance - Bakersfield, CA

If you’re shopping for health insurance in Bakersfield, CA, then you have come to the right place.  Ill give you a brief description and overview of the information you need to consider and let you know where or how to get signed up.  This information is pertinent to 2020 plan year and is subject to change (ie. COVID-19).

DISCLAIMER- READ CAREFULLY BEFORE MOVING ON: I am a licensed independent health insurance agent and I provide all of this information, handle the enrollment process from start to finish, free of charge, for all of my clients.  If you’d prefer to have someone take care of this for you and feel a like a huge burden has been lifted from you, then please text or call my office at 661-432-1474.  Initial phone consultations usually take 15 minutes.  If you think you can do it on your own then ask yourself, “can I get this done in less than 15 minutes?” Because thats how long it will take me.  So, I’m telling you, just stop reading now and call me. You will feel so much better that you did.  My services are free.  It’s a no brainer:) Please note that ill be interjecting my thoughts, sense of humor, and wisdom into this article.  It’s my attempt to lighten the article and make it a bit more fun to read.  I hope you find it at least marginally helpful.

​You need to buy coverage.  Now what? 

1.  Employer Sponsored Coverage/Group Health Plan
This is the first place you should consider buying health insurance.  With the exception of Medicare, If you are able to purchase “affordable” group health insurance through your job, or through a spouse, then you probably wont benefit from enrolling in any of the other options, especially CoveredCA where you will be excluded from any premium assistance.

Employer health insurance usually has these advantages:

• Accepted by a wide range of doctors
• Should be the most affordable after your employers contribution
• Your contributions are withheld from your paycheck prior to payroll and income taxes, therefor saving you between 15-30%.
• If you work for a company with more than 100 employees, your coverage is usually better than plans sold through CoveredCA, and will allow you to see more doctors than MediCal and MediShare.

The one downside to employer sponsored coverage:

• it can be expensive to add dependents.  But this can vary from company to company.

You need to enroll in your group health plan within 90 days of your hire date, unless you have a qualifying life event (explained below).

Once again, if you are offered coverage through your work, with the exception of Medicare, it probably doesn’t make sense to read on because these options wont make sense for you.

2. CoveredCA
Individuals under the age of 65, and not eligible for a group health plan through work, should always start out by shopping for coverage with Covered California (or CoveredCA), this is the state run exchange created by the Affordable Care Act. CoveredCa is just a store that you go to and buy health insurance from.  Similar to BestBuy, when you go there to purchase a TV, you dont purchase a BestBuy TV, you are buying a Sony, Samsung, or other brand name.  So at CoveredCa, you are not getting CoveredCA, or government, insurance, you will be buying health insurance from Blue Shield, Kaiser, or HealthNet.  You can get a quote by clicking here: https://apply.coveredca.com/lw-shopandcompare/

Why go to CoveredCA?
CoveredCA could help reduce your monthly costs by a SIGNIFICANT amount in the form of premium assistance, or tax credits.  CoveredCA uses 2 factors to determine if you are eligible for premium assistance:

• family size
• income

Click this link to see the 2020 qualification chart: https://www.coveredca.com/PDFs/FPL-Chart.pdf

CoveredCA could enhance your benefits SIGNIFICANTLY.

• Only those enrolled through CoveredCA are eligible for the Enhanced Silver Plans, eligibility for these plans is based on your family size and income.  Click this link to see how much better the plans are to others: https://www.coveredca.com/PDFs/2020-Health-Benefits-table.pdf

When dealing with CoveredCA, here is a very helpful translation:
Family size = how many people will be on your tax return when you file next spring?
Income = make a projection for the current calendar year, for all of 2020, and estimate what your total adjusted gross income will be, from all sources.

Word of caution: this is where most people screw up.  Its really important to note that CoveredCA is asking you to predict the future and AND NOT LOOK BACK when determining how much money you will make and who will be claimed on your tax return.  Because of this, they will allow you to make adjustments to your projected income and family at anytime.  These adjustments WILL affect how much you pay each month.  

What are the drawbacks to CoveredCA?

• IF you estimate your monthly income too low and subsequently make more money then you stated on your CoveredCA application, then you will owe money back when you file taxes.   The tax penalties can be severe.  This usually comes as a very unpleasant surprise at tax time, you are expecting to file and get a refund but instead wind up owing money.

This is why its highly recommended that you enroll with an agent, like me, who has experience and can help walk you through this process.  I also work with a CPA to ensure my clients are accurately projecting income and wont be penalized, and send out reminders to my clients throughout the year to remind them to update their income with CoveredCA.

• CoveredCA also “splits households,” meaning they will enroll the adults onto a health insurance plan and the children into MediCal.  This can be confusing, time consuming, and ultimately disastrous for your health insurance because MEDICAL WILL CANCEL YOUR HEALTH INSURANCE if you do not respond to their requests in a timely manner.  They WILL NOT NOTIFY YOU OF THE CANCELATION. They will cancel your coverage with Blue Shield, Kaiser, and HealthNet, AND cancel children’s MediCal coverage. 

If you are my client, I will advise you through the MediCal enrollment process to ensure you do not lose your coverage.  If you do lose your coverage, I will get it re-instated for you.

You can enroll during the open enrollment period each year (October -January), or you have 60 days to enroll through CoveredCA after a qualifying life event: 
- having a baby, adopting a child
- getting married or divorced
- dependent losing coverage
- change in employment status
- Moving to the US
- Moving within the US

Use these links to see which doctors accept CoveredCA health plans:

Blue Shield: https://www.blueshieldca.com/fad/home
Kaiser: https://wa-doctors.kaiserpermanente.org/?network_id=9&geo_location=35.33992841119684,-119.01824589961392&locale=en_us&ci=kaiserpermanente
HealthNet: https://www.healthnet.com/portal/providerSearch.action

3. COBRA
COBRA law allows you to remain on an employer plan if you were previously insured through your work.  Cobra is generally an expensive option but worth considering if you have pre-existing conditions or if you are in the middle of serious medical treatment.  Electing COBRA coverage will allow you to keep your doctor, keep your current medications, and continue with treatment with minimal disruption.  It is possible to enroll through CoveredCA and accomplish the same things, but usually switching insurance is disruptive to treatment and any pre-authorizations you may have received for medications and procedures.  

You have 60 days to elect COBRA coverage.  The coverage will start, and be back-dated, to the day you lost your coverage through work.

4. Your spouse’s health insurance through their work
The benefit to enrolling onto your spouses plan is that your monthly costs will be payroll deducted and could save you 15-30% on taxes.  The drawback to being enrolling on your spouses plan is that employer sponsored coverage is usually very expensive, but its always worth weighing this option against the others.

You have 60 days to enroll onto a spouses plan after the qualifying life event.

5. Medicare
Medicare is usually the best option for those over age 65, or for those who have been disabled for more than 2 years.  It’s very rare that someone is entitled to Medicare and chooses to enroll in something else, but it does happen from time to time.  Medicare usually costs $144.60 per month, but can increase if you are a high income earner.  To enroll in medicare you need to create a “my social security account” here: https://www.ssa.gov/benefits/medicare and enroll in parts A and B.  You will also need to decide between a Medicare Supplement or Medicare Advantage plan.  To do this requires another article.  Click here.  Medicare Supplements and Medicare Advantage plans have an additional cost above the $144.60 you pay to Social Security.

Timing your medicare enrollment is tricky and requires too much information for this article.  Please call my office if you think you may be eligible.

Pricing for Medicare is also tricky, but you can get a general sense of monthly costs here: https://jsa-ipc.destinationrx.com/plancompare/2020/Consumer/Type3/ 

(Dont forget to add in $144.60 for Medicare part A and B.  Prices could be higher based on income, click here to see costs: https://www.cms.gov/newsroom/fact-sheets/2020-medicare-parts-b-premiums-and-deductibles)

Which doctors accept Medicare:  again, too tricky to answer because the doctors can be “grouped” together in medical groups and IPA’s.  It also varies with each plan you choose.

I offer a full medicare enrollment consultation that reviews doctors, drugs, monthly prices, and coverages.  Transitioning and enrolling into Medicare is vitally important for EVERYONE and requires much more information than can be written here.  If you’re turning 65 in the next 12 months or have been disabled for over a year, please call my office to schedule an appointment.

6. MediCal
(Californias state Medicaid program for low income individuals and families)
If you are struggling financially, this is your best option.  MediCal is usually free for its members.  You are limited on which providers you can see (think Omni and Clinica Sierra Vista) and there can be lengthy delays when dealing with MediCal customer service, for instance if you need to add a newborn baby to the plan or would like to update your personal information.  However, most MediCal recipients are able to receive good medical care and will pay very little, if anything, for it.  

Click here to see a MediCal eligibility chart: https://www.dhcs.ca.gov/services/medi-cal/Pages/DoYouQualifyForMedi-Cal.aspx

If you think you may be eligible for MediCal, you can apply at anytime by clicking this link: https://c4yourself.com/c4yourself/index.jsp

Which doctors accept MediCal: https://www.healthcareoptions.dhcs.ca.gov/choose/find-provider

7. Christian Health Care Sharing Ministries
These are accurately branded as the “affordable, Christian alternative” to health insurance.  Members will save on average of 50% what they might pay for a traditional health plan.  These plans are NOT HEALTH INSURANCE, and they offer NO GUARANTEES of payment toward you claims. Having said that, and using the past and a good predictor of the future, MediShare has paid well over 4 billion in claims, on-time, for the past 25 years.  

I recommend MediShare.  You can get a quote and enroll here: https://www.htfshare.com/#/0035A00003hsBjdQAE/apply?source=portal

If you think you may be eligible for MediShare, you can apply at anytime.

Because of the strict enrollment requirements, I only recommend MediShare to devoted christians who adhere to biblical principals and lifestyle.  

Which doctors accept MediShare: 
https://www.multiplan.com/webcenter/portal/ProviderSearch?SiteId=84499&__hsfp=3047101839&__hssc=119087446.1.1575323888900&__hstc=119087446.c7baa927ce853d05f4ed57b7fe6eec27.1569328048405.1575292265780.1575323888900.60&hsCtaTracking=46711f40-587d-4a06-b75b-adefc1165078%7C8a2e8b8b-095c-48a2-8446-c57ea211db07

​Summary

If you are serious about purchasing health insurance coverage then I hope you found this information useful.  But I know that buying health insurance on your own is extremely difficult for the average person.  This article doesn’t even begin to cover price, provider networks, and coverages. Then once you select a plan, you have to actually go through the enrollment process which is where most errors occur.  I have been an agent for 11 years and most of my new clients will call me asking for help throughout all stages of the buying process. Read through my client testimonials here, and save your self some time and effort by giving me a call.  I’d love to help you.  I’d love to make a complex decision simple.  I’d love to relieve your stress.  I hope to hear you say “ Thats it!?  We’re done already!?”  Health insurance is really boring and heavily regulated industry, but the feed back I get from helping people keeps me motivated.  I hope I can help you soon.