Surprisingly, despite us still being in the middle of the Covid-19 pandemic, for 2021, we are seeing a record low rate increase of a weighted average of 0.6% through Covered CA and across the state of California. If you shop and switch to the lowest-cost silver plan, you may even save an average of 7.3%. California continues a state-enforced tax penalty for not having Affordable Care Act-compliant health insurance which is either 2.5% of household income or $695 per person/$2,085 per family, whichever is higher. California is using the funds collected from the tax penalty to continue subsidizing the health insurance premiums of the middle class within 400-600% of the Federal Poverty Level Chart. Many Californians have experienced a change of income and might be eligible for premium subsidy in 2021. Blue Shield of California, Kaiser, and LA Care are showing rate reduction of 3-5% in 2021 while Oscar and Health Net show premium increases.
Metal Tier Changes
- Bronze – $400 increase to the individual out-of-pocket maximum per person or $800 per family ($8,200 per person, $16,400 per family)
- Silver- $400 increase to the individual out-of-pocket maximum per person or $800 per family ($8,200 per person, $16,400 per family)
- Gold – $400 increase to the individual out-of-pocket maximum per person or $800 per family ($8,200 per person, $16,400 per family). Primary care & urgent care visit copays increases by $5 to $35 versus $30 in 2020
- Platinum – no changes
Anthem Blue Cross
- Expanding into Inyo, Mono, Imperial & Kern Counties for EPO options
- Expanding into Orange county for HMO options
- NEW LA hospitals – Adventist Health White Memorial & Good Samaritan
- NEW LA medical groups- Applecare, HealthCare Partners, Monarch
- NEW OC hospitals – Anaheim Global & Fountain Valley Regional
- NEW OC medical groups – Family Choice, Monarch and Prospect
- Free virtual visits through LiveHealth Online
Oscar
- HSAs or Health Savings Accounts are back! It is the lowest Bronze HSA plan in the region 16
- Virtual Pharmacy Care & Virtual Primary Care visits are free of charge
- Circle EPO adds Cedars-Sinai to its network – not available in Covered CA.
- NEW – Now available in San Mateo (Price Region 8)
- Rates of Oscar are very similar to Kaiser rates in region 16,
LA Care
- CVS Minute Clinic for minor illnesses & injuries, skin conditions and treatments, gynecology & vaccinations
- My Health In Motion health education services provided at no cost with free gift cards for a health appraisal and/or wellness program
- NEW Hospitals- Providence St Johns, Kindred, LAC/Harbor-UCLA and limited UCLA access (must assign a PCP from UCLA before they reach capacity)
- LA Care offers the lowest Bronze plan in region 16
Blue Shield of California
- Heal On-Demand house calls now offered to Trio HMO & PPO members in San Francisco, Bay Area, Sacramento, Orange County, Los Angeles, Inland Empire, & San Diego
- Dental will now be offered through Covered California
- Rates on average are dropping 2.4% from 2020
Health Net
- NEW Babylon digital healthcare provider allows you to speak to a doctor 24/7
- Health Net offers a wide HMO network – rates are slightly decrease for the HMo
- Health Net PPO rates show a 10 % increase
- Heal available for EnhancedCarePPO members
- Now offering Keck of USC for EnhancedCare PPO members
MolinaCare
- Lowest cost Silver, Gold & Platinum metal plans in West LA (Region 16), Riverside & San Bernardino (Region 17), San Diego (Region 19), and Imperial County (Region 13)
- $0 telehealth visits through Teladoc in 2021
HSA Contribution Limits
- $3,600 per person or $7,200 per family for 2021, a $50 increase per person or $100 per family from the 2020 contribution limits
Covered CA
- now offers vision plans from EyeMed & VSP (previously only offered dental plans)
- Blue Shield is will now offer dental PPOs through Covered CA
With all of the changes to the health insurance marketplace in 2021, it is important to spend at least 30 minutes reviewing your health insurance for the new year. Renewals begin October 1st while anyone else can apply as early as November 1st for a January 1st effective date. At Solid Health Insurance Services, we are always happy to assist you with your health, dental, vision, life, and long-term care insurance needs. As independent insurance brokers, our goal is to find you the right plan that fits both your medical needs and budget. Please contact us at 310-909-6135 or at info@solidhealthinsurance.com so that we may better assist you.