PacifiCare of California will soon merge with United Health, a huge insurance company, with a very good PPO network in California. The merger will strengthen one of the main weaknesses of PacifiCare’s small group and individual health insurance plans: their limited number of PPO providers. Assuming that the merger is approved by regulatory agencies, the expanded PPO network for doctors and hospitals should be available by about April 1, 2006. As of October 2005, PacifiCare of California offers two $1,000 deductible small group PPO health insurance plans: PacifiCare Signature Options 35/70-50/1000 and the PacifiCare Signature Options 35/50-50/1000. Both of these are well priced however the 50-50 plan has both a lower monthly premium and a lower co-insurance maximum (i.e., better benefits.)
The PacifiCare Signature Options 35/50-50/1000 PPO plan seems to be a better buy than the PacifiCare Signature Options 35/70-50/1000 PPO plan. The 50-50 plan has the same doctor’s office copayment, the same prescription medicine benefit and the same $1000 calendar year deductible. Most importantly, the 50-50 plan has a much lower out of pocket maximum than the 70-50 plan and it is less expensive. This may be an aberration which PacifiCare of California may change, but for now the 50-50 plan seems to be a better buy if one is concerned about having a low monthly premium and a low co-insurance maximum. Note that the deductible on both plans is paid in addition to the co-insurance maximum, so that the total out of pocket maximum is $1,000 greater than the amounts shown above. Also, many services, such as the doctor’s office visit charge and payments for prescription medicine do not apply to the out of pocket maximum, since PacifiCare limits it’s maximum to co-insurance and not all medical expenses. |
|||||||||||
|
California Health Insurance |
Group Health Insurance in California |
Health Savings Accounts | |
|||||||||||