A lot of people in Irvine buy their own health coverage because of how they work. Contractors, consultants, and early startup staff often have no plan at work. Early retirees are in the same boat. The route is the same for all of them, and it starts with one choice about networks.
Network first, price second
Most people open a plan comparison and sort by monthly cost. That is the wrong first move. The network decides whether you keep your own doctors. That is much harder to undo than a budget tweak.
What the three letters mean
HMO
One network and one primary doctor, who refers you to specialists. The monthly cost is usually easier. Care outside the network is not covered, apart from emergencies.
PPO
No referral needed, and some payment toward out of network care. Expect a higher monthly cost in return.
EPO
Usually no referral, but nothing is paid outside the network. The network is the whole deal.
Read more on HMO, PPO, and EPO plans before you decide.
Where to buy, and what help exists
Covered California is the state marketplace. You can also buy a plan straight from an insurer. Benefits are built to the same rules. Only a marketplace plan can carry a subsidy toward your monthly cost. That subsidy is set by the income you expect for the year and by your household size. We quote no figures here, because the honest answer depends on your own numbers. Check it at coveredca.com, or let us run it with you.
We are a licensed private agency, not a government entity. Harmony SoCal Insurance Services has served Orange County since 1987. Mark L Brandenburger holds California license #0718082.
Tiers are a budget dial
- Bronze: a small monthly cost, and a large share at the point of care.
- Silver: the middle, and the tier where extra cost sharing help applies.
- Gold and platinum: more each month, much less when you use care.
- Catastrophic: open to a narrow group, and it pays little until a high bar is met.
Income that moves
Contract income rarely sits still. Report changes to the marketplace during the year. Your subsidy is based on what you expect to earn, and it is trued up at tax time. Reporting as you go avoids a surprise.
Timing, and the windows that open
Open enrollment runs once a year. Outside it you need a qualifying life event. Leaving a job, losing a plan, moving, marrying, or having a baby all count. A contract ending counts when it took your coverage with it. Each window is limited, so call on the day you know.
When Medi-Cal is the answer
If your household income is low enough, Medi-Cal is usually a better route than a marketplace plan. A lean year for a contractor can put a household there. Children often qualify when the adults do not. We check both and apply for whichever fits, at no cost to you. Medi-Cal takes applications in any month.
Verify before you enroll
- Look up each doctor in the directory for that exact plan.
- Check that the plan is sold in your ZIP code, such as 92604 or 92620.
- Match your prescriptions to the plan drug list.
- Ask whether you need referrals for the specialists you already see.
How we work with Irvine clients
Irvine sits in Orange County, the same county we are based in. Our office is in Orange, a short drive north through Tustin and Santa Ana. Most clients prefer phone or video anyway, and we are glad to work either way. We compare plans across the carriers we represent, and not every plan sold here is one we offer. Our help costs you nothing. Nearing 65? Medicare in Irvine picks up from there. Otherwise contact us and we will start with your doctor list.
Health insurance options for Irvine residents
Why Irvine residents work with us
- Group benefits expertise for Irvine startups.
- Independent - we compare 12 carriers, not one.
- We work with you in English or Spanish, from the first call to enrollment.
- Same agent year-over-year - no call-center rotation.