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Health Insurance in Oakland, California

Health insurance is essential for maintaining your health and well-being. Injuries, illnesses and other conditions may be impossible to avoid entirely, regardless of how safe, healthy or risk-averse your lifestyle may be. Without adequate health insurance, you may lack the resources to recover.

How Does Health Insurance Work?

Like most types of insurance, your health insurance policy acts as an agreement between you and your insurance company and can provide you with financial assistance in response to various medical needs. You can shop for coverage on the health insurance marketplace, or your employer may offer health plans. Coverage through Medicare may also be available to people 65 and older or those with chronic conditions or permanent disabilities.

When choosing a health insurance plan, you should consider the following primary components of coverage:

  • Premium—This is the amount you will pay regularly (e.g., monthly, annually) to maintain your coverage.
  • Deductible—This is the amount you must pay out of pocket within a single plan year before your insurance contributes to further health care costs.
  • Co-pay—This determines fixed out-of-pocket costs for various medical services, such as visiting specialists or getting X-rays.
  • Out-of-pocket limit—This part of your policy establishes a maximum amount you can be required to pay out of pocket for covered health care within a plan year. After reaching this amount, your insurance will cover all approved additional costs.

What Does Health Insurance Cover?

Health insurance is customizable and may often be adjusted or enhanced to suit your needs, circumstances and budget. Although the specific capabilities and limitations of your policy may vary, the Affordable Care Act requires that all plans offered on the health insurance marketplace include coverage for the following:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including dental and vision care

Health insurance generally includes coverage for prescription drugs. Your policy must include access to preventive health services, such as annual physicals, screenings and immunizations at no cost.

How to Get Health Insurance

Burns Employee Benefits Insurance Services is prepared to help you determine the best coverage option for your health care needs. To learn more about health insurance or to get started with a policy, reach out to an agent today.

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