Aetna Health Insurance Leaving California – Recommended Replacement Plans

Health Insurance        announced they are leaving the California marketplace for individual and family plans. The end date of all their plans is December 31, 2013. All 49,000 clients still have six months to figure out what health plan they should move to. In this article we’ll give you a simple mapping that recommends which plans you should move to based upon the  health plan you currently have, a “gotcha” to watch out for, and a couple of silver linings to feel good about.

The simplest way to replace your   Health Insurance is to simply look for an alternative plan with the same (or similar) deductible amount. The recommendations below will make that easy to do. With just a little more effort, you could re-think what you need in yearly medical benefits and pick a plan the is a better fit for your current needs. Either way, you should be able to find a good solution listed below.

Health Insurance Underwriting Is More Lenient

This will be the gotcha for some people. has always been more willing to accept people with some health conditions. I know a number of my clients are in  plans because they had specific health conditions that the other carriers either would not accept, or would “rate” much higher than So this is something you have to be aware of and be careful about.

If you have existing health conditions, or are “too short” (okay… a little over-weight), or have a rated plan with   then you should definitely talk to a broker before you apply with another health insurance company. You’ll want to have the broker do Screen Requests for you to see how the other insurance companies will treat your application.

It’s important to do the -screen step first, because if you just pick a health plan, apply for it, and then get declined or rated even higher, it will be very hard to get other insurance companies to consider your application.
Let’s start mapping replacement plans…

Open Access MC Value Plan Alternatives

The   Open Access Value plans are  low-cost option. The Value plans offer a number of different deductibles, $8,000, $5,000, $2,500, and provide 3 office visits for a simple copay, and coverage for Generic prescriptions.

This plan description matches very closely to what is offered in the Anthem Blue Cross plans. If you only need two office visits rather than three, then the best choices are the Health Net  Advantage plans and   plan from Anthem Blue Cross.

If cost of the plan is one of your major factors, then here is how the alternative plans above should be used.

Health Net  Advantage 3500 – offers the best overall value (cost vs benefits)
Health Net  Advantage 6500 – is usually the lowest cost option
Anthem Blue Cross  3300 – Anthem’s lowest cost solution
Anthem Blue Cross  – closest match to Open Access Value 8000, but lower cost
Anthem Blue Cross   comfortable with lower deductibles
In the majority of cases, the alternative plans from Anthem and Health Net will be lower cost than the comparable  Value plans. You’ll need to review health insurance quotes to see how the pricing looks for your location in California.

alternative plans from all major health insurance companies in California. The best plans!

Open Access MC Plan Alternatives

The Open Access plans are  ‘s high-end offerings. These plans offered unlimited office visits for just a copay, provided both Generic and Brand name prescription coverage, and offered deductibles of 5,000, 3,500, 2,750, and 1,750.

The best mappings of the Open Access plans are the following:

Open Access Value plans –  entry plans, but very similar to  plans but without brand name prescription coverage
Anthem Blue Cross Premier plans – these plans are the top of the line from Anthem
Open Access plans – the high-end  plans
Blue Shield Shield Secure Plus plans – Blue Shield’s top end plans
Health Net does not have any plans that provide unlimited office visits and coverage of brand name prescriptions, so there are no options listed.

Open Access MC High Deductible Plan   Compatible) Alternatives

These are   entry in the Health Savings Account  compatible market. Like   plans, they provide no benefits except zero-cost preventive care until after you reach the deductible. The plans come with two deductibles, either 5,500 or $3,500.


Health Savings 4900 plan – good general purpose plan
Anthem Blue   – Anthem’s last remaining
Are You Looking For Lower Out Of Pocket Risk?

Some shoppers may be looking to lower premiums AND lower the  ‘s they have had in the past. If this is your wish, then here are a couple of options you should explore:

deductible, and the plan offers unlimited office visits
These alternative plans will cost a little more than the direct replacement options listed in the sections above. However, the attractiveness of having lower risk if an accident or a medical condition starts is very compelling.

Silver Linings In The  Health Insurance Decision

I believe  s just the first in a line of large and small health insurance companies that will leave the California individual and family health insurance marketplace over the next 3-5 years had a very small market share, and would have a hard time competing with the insurance companies that dominate the California market. So having    leave now will reduce the turbulence we see during the Health Care Reform roll-out later this fall.



The last silver lining of this change a , is that   plans have not been very competitive the last couple of years. So changing to comparable plans will give you a reduction in premiums. With the information we’ve given you above, you should be able to find a good  replacement plan, now go forth and prosper.

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