I love my friends. Really, I do.
But sometimes they do things that make me want to Anderson-Silva my own shin in half. Like post dumb things such as:
In case you missed it, this is what I mean by “Anderson-Silva”
I understand the frustration. Especially if you work in Hollywood:
Assistants work for producers, who insist it’s a great learning experience, but they just can’t afford buying them health insurance.
Actors / waiters wait tables or tend bar between gigs, for an employer who doesn’t offer health insurance.
The recently unemployed, out of a “secure job” and scouring LinkedIn, who think their only choice for health insurance is COBRA at $460 per month. Which seems like an awful lot for something you probably won’t use. Especially when you have no income.
However, I live in the real world.
The real world doesn’t care about your rants against “the man” or how much you despise “the system.”
In the real world, nationwide health care is happening. It’s an (admittedly) imperfect system. But it’s a system implemented so that no matter your income level, if you get T-boned by some asshole in a Prius trying to beat the red on La Brea, your medical bills won’t bankrupt you…
Yup, that’s the real world, my friend.
Bunch of assholes driving around in Priuses (Prisui? Anyone?)
What You’ll Learn By Reading This Post
You may know absolutely nothing about health insurance, Covered California, or the difference between an HMO and a PPO.
I didn’t either.
When you finish reading, you’ll be able to sign up for the health insurance plan that best suits your needs, confident you got the best price, in under 45 minutes — just by following the procedure, step-by-step.
To qualify for Health Insurance by March 1, 2014, you must apply by February 15, 2014.
Who Is This Post For?
This is for young people working in Los Angeles.
For Hollywood Assistants, yes.
It’s for waiters and bartenders, who make mostly a cash-in-hand living – which I did for 11 years.
It’s for personal trainers, baristas, and freelance web designers.
Also for the thousands hustling on the side, who use TaskRabbit to get work assembling Ikea furniture, Craigslist to bounce at a club, or Lyft to become their own independent taxi cab.
I love you guys for the hustle.
And I want you to see the process of getting health insurance in California is not scary or intimidating. Keep reading.
(If you want to make sure you don’t miss any of this material, sign up to receive emails sent right to your inbox (it’s free.))
Here Are My Assumptions about YOU
- You reside in California. (If this doesn’t apply to you, stop here. If you still have an out-of-state ID, stop here. I’m covering Covered California and this won’t apply to you.)
- You no longer receive health insurance from an employer.
- You’re older than 26 and/or are not covered under your parent’s insurance plan.
- You’re relatively healthy with no pre-existing conditions, and if you stopped drinking so much, you’re certain you’d live a long and healthy life.
- You want to get health insurance — but you’d like the most inexpensive option possible, please.
I’m not diving deep into all the particulars of Patient Protection and Affordable Care Act (aka Obamacare), its history, and all the ways it changes your life. If you want to dive deep, I encourage you to read this supplemental material:
- Everything you need to know about life under Obamacare by Sarah Kliff
- Ultimate guide to buying insurance on HealthCare.gov by Sarah Kliff
- Covered California website
How Much Is Health Insurance Going to Cost Me?
That depends — how much do you make?
If you annual household income is less than $45,960 (or less than $94,200 if you’re a family of four) you may be eligible for premium assistance.
Premium assistance reduces the the cost of the monthly premium.
If your annual household income is less than $28,735 (or less than $58,875 if you’re a family of four) you may be eligible for cost-sharing subsidies.
Cost-sharing subsidies reduces the costs of care you actually receive.
In other words, when you do get care, you pay less out of pocket.
Annual household income is based on AGI (adjust gross income) of each person in your household purchasing health insurance.
No, you can’t deduct for taxes.
Still not sure what you make? Here’s a quick cheat-sheet of common Hollywood Assistant salaries, and their AGI:
If your annual household income is more than $45,960, you probably won’t qualify for any assistance. In that case, here’s the general range of premiums for your health insurance:
Bronze plan for a 27-year-old male: $161 to $186 per month.
Bronze plan for a 25-year-old female: $154 to $178 per month.
Silver plan for a 27-year-old male: $200 to $220 per month.
Silver plan for a 25-year-old female: $192 – $210 per month.
What’s the difference between Bronze and Silver?
We’ll get into that below.
What you need to take away is this: on the Bronze plan, you pay a lower premium, but higher deductible or co-pay.
You pay less up front, but more on the back, when you actually use your insurance.
On the Bronze plan, in exchange for a lower monthly price, you’ll pay more out-of-pocket.
Makes sense, right?
Do I Have Options Beyond Bronze and Silver?
Yes: Catastrophic, Gold, and Platinum.
Catastrophic is your bare bones health insurance. While cheaper than Bronze, it only covers essential health benefits plus three visits to your primary care physician per year. This plan can only be bought by people under 30 or those exempt from the individual mandate.
What are essential health benefits?
At the Gold-level, your monthly premium is even higher, but you pay less in deductibles and co-pays. The same for Platinum — more upfront costs so you pay less on the backend.
So… Which Insurance Should I Buy?
If you’re in the targeted demo I mentioned before: mid 20’s to early 30’s, living in Hollywood, an assistant or someone hustling to make a living on the side and cost-conscious, I’d recommend Bronze or Silver.
If you’d like more coverage are willing to pay more up-front, I encourage you to head to Covered California and do more research.
What Does My Plan Cover?
Your plan covers Preventative Services. A list is below. This includes your yearly check-up at zero co-pay (however, if you eventually pay a co-pay, it may not count towards the deductible).
Here’s a full list of Preventative Services:
And a full list of Preventative Services for women:
Do I Get Dental or Vision Coverage?
No. Right now, dental and vision coverage can only be purchased for children.
I’m Really Not Sure What Level or Insurer to Pick…
Ultimately you must decide for yourself. A few things to remember:
- Today’s choice is not forever. You can change your plan after a year.
- If you’re relatively healthy, take care of yourself, and can’t foresee any reasons why you’ll be in the hospital, get a lower plan.
- If you’re at the hospital or doctor’s office more regularly, go with the “higher” plan. You’ll pay more upfront but save money on the backend.
Regardless of what I say, you must make your own choice. You must understand your risks. So please do your own due diligence.
Here’s a breakdown of costs of care on the Bronze and Silver Plan.
Here’s a breakdown of Bronze, Silver, Gold, and Platinum:
Okay, Let’s Do This: How Do I Actually Buy Health Insurance?
Below, I’ll take you step-by-step through the process of buying health insurance. At the end, you’ll be ready to buy. Remember: you must purchase by February 15, 2014 for your coverage to start on March 1, 2014.
Total time: 45 minutes:
1. To sign up for Covered California, go here: https://www.coveredca.com/. Go to Account Login, then Set Up An Account. Select Individual or Family.
2. You’ll enter your information and fill out forms to create your account. Remember to write down your username and password.
3. You’re all set. Now, log-in.
4. Answer 5 security questions.
5. Get ready to get personal — here’s what you need to fill out: contact information, information about household members, current income, if you’d like to apply for financial assistance (check yes, even if you don’t think you’ll get any — you never know). It can get tricky if you work as an outside contractor (as I do) and you can deduct expenses from your income.
6. You’ll plug in other deductions: student loans, Roth IRA, etc.
7. You’ll receive a breakdown of you’re qualified for, including financial assistance.
8. You’ll answer questions about your household and preferences. Then, you choose what level of health insurance to buy.
9. Then, time to shop. Here are the details that really matters:
HMO vs PPO vs EPO
HMO’s (health maintenance organization) generally have low monthly premiums and low cost-sharing (deductibles, copayments and coinsurnace), however, require primary care physician referrals to see specialists and only pay for out-of-network care in emergencies (the insurer needs to agree it was an emergency).
PPO’s (preferred provider organization) generally have higher monthly premiums and higher cost-sharing, however, they are much less restrictive about providers you can see. They have a network of physicians they prefer, however, are willing to pay for out-of-network care.
EPO’s (exclusive provider organization) are a more restrictive form of PPO’s. They share the same benefits, minus the perk of paying for out-of-network care (you must use their network exclusively) if you want them to pay.
ER Urgent Care
What plan did I choose? I picked Anthem Blue Cross at the Bronze Level.
- Part of the reason is the brand name (I’m not familiar with LA CARE).
- I rarely visit the doctor, and I’m happy with my selection in-network.
- The backend is a bit more expensive as I’d have to hit the deductible before the insurance kicks in, but I have savings for those kind of emergencies. I’d rather save money on the front-end.
My monthly premium: $161 per month.
10. Watch out for paperwork that’s supposed to come in the mail. The paperwork will explain how you make your first payment. You are not enrolled until you’ve made your first payment, so please put into your calendar to call if you don’t receive paperwork after two weeks.
11. Once you’ve made your first payment, go find a doctor in your network.
Congratulations! You bought your own health insurance.
Like a real grown-up!
I meant it when I said I love you people — people who hustle, who understand you still have to make cash on the side as you pursue your art.
You inspire me.
And is there’s any way for me to help, I’ll do it.
So if you go through this ultimate guide on buying health insurance, and still don’t know what to do, I want to help. Here’s what you need to do:
- Personal message me via Twitter — I’m @thisisming and you can follow me on Twitter by clicking here
- I’ll ask you to PM who you are, your source of income, and how much you make
- I’ll ask you to PM me the best way to contact you (e-mail, phone number, etc.)
And I’ll email you.
Or call you.
We’ll figure it out together.
I’m doing this because we live and work in the real world, and obtaining our own health insurance is an important part of that.
We don’t have time to complain about “the man” or “the system.”
We’ve got real work to do.
Photo Credits: all images not mine are screenshots from the Covered California Website