Frequently Asked Questions About Health Plans

eCaliforniahealth Insurance Services provides individual and family health plan information for California residents.  Available plans include Health Maintenance Organizations (HMO's) and Preferred Provider Organizations (PPO's) from popular health insurance carriers.

Is an Individual and Family Plan right for me?

Individual and Family Plans may be right for you if you are:

Self-employed or not covered under a group plan;
Not satisfied with the group plan you’re now on or would like to cover family members
outside the coverage offered by your employer
;
Seeking protection from major healthcare expenses such as unexpected accident or
illness.

What is the difference between a PPO and an HMO?

Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans offer different ways to access medical care, charge different types of copayments for covered services and feature different monthly rates.

Health Maintenance Organization (HMO) Generic Features

Receive many covered services right away at no charge or for a fixed copayment

Choose a Personal Physician from an HMO network which provides, refers and coordinates your medical care; and
Receive all medical services from providers in your Personal Physician’s medical group or IPA.

Preferred Provider Organization (PPO) Generic Features

Choose your own providers each time you seek medical care;

Access reduced charges through the plan provider’s Preferred Provider Network;

Receive some preventive care benefits even before your meet any plan deductible;
and
Pay a percentage of charges for most covered services after you meet any applicable plan deductible.


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