Napa's Health Insurance Guys: Newly single Napan needs health insurance

Dear Kyle, Tom and Alan:

I'm recently divorced, just moved back to Napa from SoCal and my next birthday is my 48th.

I've got a new job that pays well but has no benefits for six months or so. I'm in good health and need some health plan to last until the benefits kick in.

Not too expensive, OK?

Jerry

Kyle: All right, Jerry, we're going to assume you make too much money to go through Covered California and get a subsidy. Although be sure to let us know if things change. Anyway, we'll give you a quote as though you are going direct to the insurance company to apply (yes, that's still allowed!)

Tom: The least expensive plan for Jerry will be the Western Health Advantage (WHA) Bronze 60 HMO at $537.70 per month.

Al: The next least expensive plan is the Kaiser Bronze 60 HMO at $553.72 per month. I should point out that Kaiser also has a cheaper plan at $528.41 monthly, but this is a High Deductible Health Plan (HDHP) better known as an HSA plan. This Health Savings Account allows you to set up a separate account to fund deductibles, copays, etc., but I don't think it fits Jerry's timeframe since his employer benefits are starting soon.

Kyle: Now for some details.

The WHA plan has an annual deductible of $6,300; Primary Care Physician (PCP) visits are $65 (the first three are not subject to the deductible); if the deductible is reached, most services have a 40 percent copay until the maximum out of pocket, $8,200, is paid. In Napa, the providence network of doctors and Queen of the Valley Hospital are available.

Al: The Kaiser plan has almost the exact same numbers, but the network encompasses California. The out of pocket maximum is $8,600. Emergency services are covered in both plans even if you're out of network.

Tom: To look at the Kaiser HDHP plan a little closer for our readers who might be interested: the annual deductible and the maximum out of pocket are the same: $7,000. So pretty much everything is paid out of pocket until the $7,000 is reached. The good news is that should you ever reach that $7,000, all your stuff is covered 100 percent.

Kyle: Of course preventive care is provided at no charge because of the Affordable Care Act (ACA).

The very next plan after WHA and Kaiser is the Anthem Blue Cross Bronze 60 EPO at $641.10 per month. The coverage details are along the lines of the WHA and Kaiser Bronze plans, including deductibles, max out of pocket and copays. The Exclusive Provider Organization (EPO) part of Blue Cross seems to have limited our Napa providers.

Finally, the only Preferred Provider Organization (PPO) we have is the Blue Shield of California Bronze PPO at $772.67. Again, the details are all similar in Bronze plans, but you definitely pay for a California-wide network of providers.