Dear Tom and Alan:
Our oldest son, age 40, travels a lot for his job.
He currently lives in San Francisco, but since his work takes him all over the western states, he could just about live anywhere (even Napa!).
He’s single and makes good money. As capable and smart as he is, he does not have any health insurance!
This worries me a lot. Is there some less expensive policy I could tell him about so at least he wouldn’t lose everything if something bad happened?
Also, does it make a difference where he lives?
Tom: This is a question we haven’t seen yet!
So, to answer your question, we’ll check the rates and plans in three different places in California.
First, we assumed your son makes more than $48,000 per year. This means that he is not eligible for a subsidy through Covered California, which means he pays the “retail” rate for whichever policy he chooses.
Using the “shop and compare” tool through the website, we came up with 28 plans available to your son in San Francisco.
Here are the least expensive: CCHP Bronze HMO, $341.84; Kaiser Bronze HMO, $343.95; Oscar Bronze EPO, $383.33; Blue Shield Bronze PPO, $440.34.
By the way, the most expensive plan for a 40-year-old in San Francisco is the Blue Shield Platinum PPO at $925.59.
Al: CCHP is the Chinese Community Health Plan, and, no, you don’t have to be Chinese to get it.
The requirement is that you live or work in San Francisco or northern San Mateo County.
Oscar is a plan we’ll definitely hear about. It’s a New York- based company that received $375 million from Google’s parent firm Alphabet.
Tom: For Napa, the “shop and compare” tool came up with 20 different plans for a 40-year-old.
The least expensive is Kaiser Bronze HMO at $327.57; next is WHA Bronze HMO at $342.28; Healthnet Bronze EPO is $433.84; and, Blue Shield Bronze PPO for $458.01. Again, the most expensive is the Blue Shield Platinum at $962.73.
Al: WHA is Western Health Advantage. They are trying to expand their reach by joining with Canopy Health.
EPO is Exclusive Provider Organization. Basically, it was a PPO that narrowed the network.
So far, it looks like your son could save a few dollars by living in Napa … at least for the cheapest ones.
Tom: So what if he moved to L.A.?
Los Angeles is blessed with 35 different plans. Here are the least expensive ones: Molina Bronze HMO $263.67; Oscar Bronze EPO $263.86; Kaiser Bronze HMO $266.47; L.A. Care Bronze HMO $267.56; Healthnet Bronze PPO $286.66; and, Blue Shield Bronze PPO 367.38. Even in L.A., Blue Shield Platinum PPO is most expensive: $772.22.
Al: So that settles it! All he has to do is move to L.A. and save money on health insurance!
However, he may be subject to the penalty under the Affordable Care Act for not having had coverage.
We’re told that is still in effect until 2019.