Atención cotidiana
Chequeos, atención preventiva y medicamentos bajo el plan que incluye a sus proveedores.
Seguro de Salud
Planes individuales y familiares, con un corredor que verifica su elegibilidad para subsidios, revisa que sus médicos estén en cada red y contesta el teléfono cuando una factura se ve mal. Usarnos no le cuesta nada extra.
Cobertura acorde a cómo recibe atención realmente
El plan correcto depende de sus médicos, sus medicamentos y su presupuesto, no del último anuncio que vio. Ese emparejamiento es nuestro trabajo.
El mal año
Cobertura hospitalaria y de emergencias con un máximo de gastos que limita el daño.
Un humano a quien llamar
Inscripción, trámites de subsidio y problemas de reclamos, resueltos con usted, no en una fila de espera.
A quiénes ayudamos más seguido
- Trabajadores independientes dejando cobertura grupal
- Familias verificando su subsidio de Covered California
- Jubilados anticipados haciendo puente a Medicare
- Cualquiera para quien sus médicos importan más que el logo del plan
Qué cubre y qué no
Generalmente cubierto
- Doctor visits and preventive careCheckups, screenings, and immunizations, with preventive care covered before the deductible on ACA plans.
- Hospital and emergency careThe bills that make insurance non-negotiable: surgery, hospital stays, and the ER.
- PrescriptionsMedications under the plan's formulary, with costs that vary by tier.
- Mental health careACA plans cover mental health and substance-use treatment as essential benefits.
No cubierto aquí
- Out-of-network surprisesCare outside the plan's network can cost far more, or not be covered at all on HMO plans.
- Most dental and vision for adultsThese are usually separate policies or riders.
- Non-formulary drugs without approvalMedications off the plan's list may need exceptions or prior authorization.
- Elective and cosmetic proceduresCare that is not medically necessary falls outside the plan.
Preguntas frecuentes
When can I enroll?
During Covered California's annual open enrollment, or within 60 days of a qualifying life event like losing job coverage, moving, marriage, or a birth. Miss both and you generally wait for the next open enrollment, so timing matters.
Can I get help paying the premium?
Many Californians qualify for subsidies through Covered California based on household income, and the amounts surprise people. We check your eligibility as part of quoting, at no cost to you.
HMO or PPO?
HMOs cost less and keep care inside a network with referrals. PPOs cost more and let you see specialists and out-of-network providers more freely. The right answer depends on your doctors, prescriptions, and travel. We map your actual providers against each network before you pick.
What do deductible, copay, and out-of-pocket max actually mean?
The deductible is what you pay before the plan shares costs, copays are fixed per-visit amounts, and the out-of-pocket maximum is the ceiling on your annual spending, after which the plan pays covered care in full. The maximum is the number that protects you in a bad year.
Does using a broker cost me more?
No. Plan prices are set by regulation and are identical with or without a broker. The difference is having someone to call when a claim, bill, or enrollment problem appears.
Coberturas que combinan con esta
Verifique sus opciones y su subsidio
Unos datos del hogar nos dicen su elegibilidad y qué redes incluyen a sus médicos. Nosotros seguimos desde ahí.