A recent trend in the individual market place has been the introduction of “Low Cost – Zero Deductible – Single Only PPO” medical insurance plans.
These plans are PPO plans (meaning you choose your doctor when you need care -not when you enroll as in an HMO plan. The plans include:
* Blue Cross of California Right Plan 40;
* Blue Shield of California Active Start 25 and 35 plans; and,
* Health Net of California Simple Value 30, 40 and 50 plans.
These plans have a lot in common:
* Low monthly payment (premium) to the health insurance company;
* No deductible, which means that the insurance company starts paying for medical care right away;
* No maternity coverage, which means that if you have a baby the insurance company will not pay the associated expenses (not a good choice if you want to have a baby;)
* Single only coverage, which means that you can not have a spouse or a child on the same policy, which means that the out-of-pocket maximum/limit counts for only one person – the insured member (not a good choice if you want to cover your family because you could have to spend a lot of money if a bunch of people in your family got really sick.
* High out-of-pocket maximum/limit, about $7,500 per calendar year, which means that if you have a catestrophic illness or injury you will have to pay this high amount.
It may seem to be a paradox that a plan with no deductible would also have a low premium. You can understand the pricing when you consider the high out-of-pocket maximum/limit and the lack of maternity coverage.
Still, these are very popular plans because people pay a low monthly premium and see the insurance company paying immediately – without a high deductible.
