The Cheapest California Health Insurance for Individuals and Families
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Health insurance is typically obtained through employment or government assistance, such as Medicare or Medicaid. If you can’t get health insurance through these methods, you can purchase private plans through the California insurance exchange.
It is possible to find cheap health insurance in California’s private market, but it isn’t always the best option. This is because more affordable plans often come with high deductibles and out-of-pocket maximums, which means you’ll get less coverage and pay more if you have a medical emergency.
MoneyGeek identified the cheapest plans in the California insurance marketplace based on varying age groups and plan types to cater to various individuals.
The Cheapest Health Insurance in California by Metal Tier
In the private insurance marketplace in California and other states, plans are divided into metal tiers. These do not determine healthcare quality but rather the split of medical costs between the policyholder and the insurer, the premiums and the out-of-pocket maximums.
California has four metal tiers, including Bronze, Silver, Gold and Platinum. The average cost of health insurance in California for each metal tier based on a sample profile of a 40-year-old man is:
- Bronze: $411 per month
- Silver: $508 per month
- Gold: $584 per month
- Platinum: $754 per month
Bronze and Silver tiers are significantly cheaper than Gold or Platinum plans. However, the latter can cover your medical costs sooner and result in you paying less out-of-pocket if you frequently need medical care.
The table below outlines the cheapest plan based on the monthly premium for each metal tier. Note that in California and elsewhere, the premiums, deductibles and out-of-pocket maximums may vary significantly based on each metal tier.
Low-income individuals may qualify for cost-sharing reductions (CSR), which apply only to Silver plans. This reduces your deductible, copayments and coinsurance, making the insurance more cost-effective for those with lower incomes.
MoneyGeek collected rates for all types of plans available in California, including HMO, PPO and EPO, based on a sample profile of a 40-year-old. HMOs are the most common plan type.
Cheapest Health Insurance in California by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- BronzeBronze 60 HMOL.A Care Health Plan$264$8,200
- SilverSilver 70 HMOL.A Care Health Plan$338$8,200
- GoldGold 80 HMOL.A Care Health Plan$356$8,200
- PlatinumPlatinum 90 HMOL.A Care Health Plan$408$4,500
The Cheapest Health Insurance in California by Age and Metal Tier
Several factors are considered to determine your premiums. Aside from your location and income level, your age is also considered. In California, a Silver-tiered HMO plan for a 26-year-old costs an average of $408 per month, while a 60-year-old will pay an average of $1,080 per month.
Health Insurance Costs in California by Age and Metal Tier
The rates mentioned are averages and are based on sample ages. It’s crucial to realize that these do not consider your unique situation or combination of income and age. For instance, seniors may be eligible for tax premiums, while low-income individuals may get cost-sharing reductions. In general, you won’t know your exact quote until you apply for a plan.
Use the table below to see the differences in premiums between metal tiers and age groups. To understand what metal tier to buy, read our guide on health insurance in California.
Cheapest Health Insurance in California by Age And Metal Tier
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- PlanCompanyMonthly Rate
- BronzeHMOL.A Care Health Plan$189
- BronzeEPOOscar$215
- BronzeHMOValley Health Plan$217
- BronzeHMOAnthem Blue Cross$235
- BronzePPOHealth Net$255
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The Cheapest Health Insurance in California by County
Location is another factor that insurers consider when computing your premiums. California and other states are divided into rating areas, which insurers use to calculate premiums. There are 19 rating areas and 58 counties in California, with Los Angeles County being the most populous county.
The most affordable Silver plan in Los Angeles County is the Bronze 60 HMO by L.A. Care Health Plan, costing an average of $332 per month.
Use the table below to find the cheapest plan in your California county for all metal tiers.
Plans and rates mentioned using a profile of a 40-year-old male in California purchasing a health insurance plan in that county.
Cheapest Health Insurance Plans in California by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- AlpineBronzeAnthem Blue CrossBronze 60 HDHP EPO$451
- Del NorteBronzeAnthem Blue CrossBronze 60 HDHP EPO$451
- SiskiyouBronzeAnthem Blue CrossBronze 60 HDHP EPO$451
- ModocBronzeAnthem Blue CrossBronze 60 HDHP EPO$451
- LassenBronzeAnthem Blue CrossBronze 60 HDHP EPO$451
The Cheapest Health Insurance in California With High Out-of-Pocket Maxes
The best option for health insurance in California for an individual in good health is low-cost plans with high out-of-pocket maximums. While this gives you some form of coverage, note that you may have to pay more if you need to visit the doctor a lot within a given year or have a lot of medical needs.
The Bronze 60 HMO by L.A. Care Health Plan is the most affordable health insurance in California with high out-of-pocket maximums, costing an average of $211 per month for a 26-year-old. MoneyGeek defines a high out-of-pocket maximum as one that is $8,250 or higher.
L.A Care Health Plan
L.A. Care Health Plan offers the cheapest plan with the highest out-of-pocket max. However, it’s a Bronze-tiered HMO plan, which means it falls under the lowest tier and thus, comes with the highest out-of-pocket expenses.
The Cheapest Health Insurance in California With Low Out-of-Pocket Maximums
If you frequently need medical care and have higher medical costs than most people, opting for a high-tier plan with a low out-of-pocket max could be your best option. Having a plan within the Gold or Platinum tier will let you reach your out-of-pocket maximum easily, which means insurers will start covering the cost of doctors’ visits or prescription drugs sooner.
L.A. Care Health Plan offers the most affordable health insurance in California. Their Platinum 90 HMO costs an average of $408 per month for a 40-year-old.
MoneyGeek defines a low out-of-pocket maximum as one that falls under the $4,250 threshold. In California, however, there is no out-of-pocket max below this number. As a result, L.A. Care Health Plan’s offer has the lowest out-of-pocket maximum in the state with the cheapest premiums.
L.A Care Health Plan
The Platinum 90 HMO by L.A. Care Health Plan falls under the Platinum tier, which is the highest in the state. This means that it is the most expensive, but it also comes with a low out-of-pocket maximum, which means individuals who have many medical needs can get covered sooner.
Cheapest HMO/EPO/PPO Health Insurance Plan in California
Your healthcare needs will influence what type of plan suits you best. In California, there are three plan types, including health maintenance organization (HMO), preferred provider organization (PPO) and exclusive provider organization (EPO) plans. HMO plans are the most common in the state.
HMO plans are the cheapest, but you have limited options as you need to stick to your provider network to have your services covered and have a referral to see a specialist.
PPOs are a little more flexible in that you don’t need a referral and have access to a broader network. However, it does cost more.
Finally, EPO plans are more flexible than an HMO as you can access services outside your network in an emergency, and you don’t always need a referral to see a specialist.
The cheapest options for all plan types within the Silver tier for a 40-year-old are:
- HMO: The Silver 70 HMO by L.A. Care Health Plan, costing an average of $338 per month.
- PPO: The Silver 70 EnhancedCare PPO by Health Net, costing an average of $512 per month.
- EPO: The Silver 70 Select EPO by Oscar, costing an average of $418 per month.
Cheapest Plan in California With an HSA
An appealing health insurance alternative for those who are in good health is a plan with a health savings account (HSA). These plans are more affordable and let you build tax-free savings for health-related expenses. You can also use it for non-health-related costs, but it loses its tax-free perk. In addition, while it is an affordable option on a month-to-month basis, you may have to pay more out-of-pocket if you have a major medical emergency.
The cheapest plan with an HSA option for a 40-year-old is the Bronze 60 HDHP EnhancedCare PPO by Health Net, costing an average of $357 per month.
What to Know About Health Insurance in California
MoneyGeek gathered rates from California’s private marketplace, but note that it is still possible for you to get cheaper plans when you apply. For example, lower-income residents or elderly individuals in California may even qualify for Medicaid or Medicare, which are more affordable than any other option on the private market.
Private Health Insurance on the California Marketplace
The private health insurance market in California is divided into four metal tiers. These tiers determine the split of costs between the insurer and the policyholder and do not determine or change the quality of care.
All plans meet the federal and state minimums, but each has varying degrees of premiums, out-of-pocket maximums, and deductibles.
- Bronze: This is the cheapest tier out of all the plans, as it has the lowest premiums but the highest out-of-pocket maximums. It is the perfect option for individuals who want some form of coverage, but note that it means you’ll have to pay a lot if you have a medical emergency.
- Silver: The Silver tier provides the most balance between premiums and out-of-pocket maxes. It is also the most beneficial for those looking to save on costs, as individuals who qualify for premium tax credits or cost-sharing reductions can maximize this plan.
- Gold: Gold plans cost significantly more than Silver or Bronze plans, but the out-of-pocket expenses are lower. This is best for those who frequent the doctor or require expensive prescription drugs.
- Platinum: The Platinum plan is the most expensive in California. It has the highest premiums but the lowest deductibles and out-of-pocket maximums. This plan allows for coverage to kick in much sooner and is the best option for those who anticipate having extremely high medical costs within the next year.
Depending on your income level, you may even qualify for discounts or increased coverage compared to the ones listed in MoneyGeek’s study. For instance, if your income falls between 100% and 400% of the federal poverty level, you may be eligible for premium tax credits. This applies to a two-person household making anywhere between $17,420 and $69,680 a year.
To find out how much you can save based on your yearly income, use Healthcare.gov’s calculator.
For California residents who want to purchase private health insurance, take note of the open enrollment period. This is where you can enroll or even disenroll from a current plan. It typically falls between November and December, but the dates have been expanded due to the pandemic.
If your income falls between 138% and 250% of the federal poverty level, which is roughly $24,040 to $43,550 per year for a two-person household, you can qualify for cost-sharing reductions. This helps make Silver plans more affordable and beneficial, as it can lower your deductibles, out-of-pocket maxes and copayments, or coinsurance. You can potentially get Gold-tier coverage at the cost of a Silver plan if you qualify for these reductions.
Medicaid in California
Individuals who want cheap health insurance in California should look no further than Medicaid. This is a free option for those who meet their requirements, and as California is a Medicaid expansion state, residents can qualify based on income level alone. If your income is below 138% of the federal poverty level, you can get coverage through Medicaid.
Medicare in California
Residents of California who are over 65 years old or have a qualifying disability or illness may be eligible for Medicare. This federal government program provides aid for specific services but still requires some form of payment. They cover the following services:
- Part A: This covers any service related to hospital stays, such as in-patient care, skilled nursing facility care and certain home health care services.
- Part B: This covers doctor’s services, such as outpatient care, medical services and preventative services.
- Part D: This covers prescription drugs and any recommended shots or vaccines.
Methodology
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in California for you
MoneyGeek collected plans and premiums for health insurance in California from the website for Covered California for all available metal tiers and across several age groups. Plans and premiums were analyzed in May 2021.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About Mark Fitzpatrick
sources
- Medicare. "What’s Medicare?." Accessed June 19, 2021.