Working with the Center for American Progress, California first lady Maria Shriver is taking a serious second look at the segment of Californians who are facing unusually high risk for life-altering diseases like arthritis, cancer, diabetes and heart disease. Considering their typical work load, it’s not surprising that caregivers are almost twice as likely as others to suffer serious chronic health issues.
Who most often works more than their share to care for children and/or aging parents? The majority of caregivers are still women even though the days when most women did not put in a 40-hour week outside the home are long gone.
One of the primary findings of Shriver’s report titled “Sick and Tired” is that such double duty shows up in women’s health as more serious health effects than men have. Women not only make up half of the U.S. work force, but mothers are also the family providers for two-thirds of our families.
What Does Health Insurance For California Mean For Women?
Since the recession started at the end of 2007, 73.6 percent of the jobs lost displaced men instead of women. With thousands of women gaining access to health plans through their spouse’s employment, that has left thousands of women without health insurance. If a woman has to buy health insurance plans in California in the individual market, she typically pays more than a man even though she cannot get critical coverage for maternity and reproductive health care.
Each year the American Psychological Association conducts a survey to assess the “Stress in America.” Respondents showed that more women than men say they are stressed by the economic downturn. The economy isn’t the only high risk factor that’s likely to impact women’s health.
Women are likely to be responsible for making ends meet when the budget is tight. They’re on the “front lines” when it comes to denying their children’s requests and dealing with temper tantrums. They’re also more likely than men to work in child care or education with greater exposure to influenza and other viruses. The bottom line is that women are at high risk and need health insurance. California insurers, however, prefer to spread their financial risk with a large pool through group insurance. That leaves many women to face high premiums for partial health care coverage.
Securing California Health Insurance Is Challenging
Start by educating yourself about what the differences in health insurance for California mean for your access to health care and your budget. When you’re looking for private California health insurance, one of the first things to check is the limit on your annual out-of-pocket expenses. Once you’ve spent that much, your insurance will provide 100-percent coverage for approved health care.
That limit is important for two reasons. You’ll need to plan for a way to cover health care up to the limit, but you can also plan expected health care around it. If you need multiple procedures, having them done within the same policy year could result in significant savings.
The next limit to check is the maximum annual limit. Insurers can no longer limit the amount of coverage you may need over a lifetime, but they can impose annual limits. They may also have limits on outpatient treatment and prescriptions. Most California health insurance plans don’t pay for dental or vision health care.
If you do need prescriptions, investigate the drug formulary of your health plan. That’s a list of brand name and generic prescription drugs that are preferred by your health plan. You can ask your doctor to prescribe from this list to lower your cost and some medications may not be covered.
Learn the difference between HMO and PPO plans. With an HMO, you’ll have to pick one in-network physician who will decide when you can get coverage to see a specialist. PPOs typically have higher premiums than HMOs, but they offer direct access to all participating providers usually at significantly discounted rates. They also typically offer partial coverage to go out-of-network.
Co-payments and deductibles are still important, but they no longer apply to preventive care services. Since your annual exam and many screening procedures, like mammograms, are covered at 100 percent before you meet the plan’s deductible, you may not need a co-pay plan. That’s a plan where you pay $25 or $35 each time you see a doctor or fill a prescription. Co-pay plans usually have higher premiums than California health insurance plans with deductibles. In general, the higher the deductible, the lower the premiums will be.