Buying your own health plan in Los Angeles is mostly a network question. The county is wide, traffic is real, and the doctor you want may sit in only some plan networks. Cost matters too. This page explains how the two fit together, in plain terms.
Two doors into coverage
There are two ways into an individual or family plan. Covered California is the state marketplace. The other door is buying direct from an insurer. The rules on what a plan must cover are the same either way. The difference is money, because only a marketplace plan can carry a subsidy. We are a private agency and not a government entity, so verify whatever you like at coveredca.com.
What a subsidy depends on
A subsidy lowers what you pay each month. Two things set it. The first is the income you expect for the year. The second is how many people live in your household. Nothing else moves it as much. If your income shifts during the year, tell the marketplace, because the help is adjusted.
Metal tiers are about cost sharing
- Bronze asks the least each month and the largest share when you get care.
- Silver sits in the middle, and the extra cost sharing help attaches here.
- Gold and platinum cost more each month and much less when you use care.
- Catastrophic plans are limited to a narrow group and pay almost nothing until a high bar is met.
Tier is a budget choice. It does not tell you a single thing about which clinics you may use.
HMO, PPO, and EPO across a wide county
This is the choice that settles most cases. In a county this large, the network map is the plan.
- An HMO keeps you inside one network. You choose a primary doctor, who sends you on to specialists. The monthly cost is usually gentler.
- A PPO lets you see specialists without a referral. It also pays part of the bill outside the network. You pay more each month for that.
- An EPO often drops the referral step but pays nothing outside the network.
- Emergency care is covered on all three, wherever you happen to be.
Plan menus are approved county by county. Glendale, Pasadena, and South Gate all sit inside Los Angeles County, so the list there looks like yours. Cross into Orange County and the menu is different. A move like that is also a qualifying life event, so you would be choosing again anyway.
Check your own doctors first
Five minutes that prevents a year of regret
- Search each doctor by name in the directory for that exact plan.
- Check the clinic you would really use, not just the nearest one.
- Confirm the plan is offered in your ZIP code, whether 90011, 90019, or another.
- List your prescriptions and look each one up on the plan drug list.
- Ask us to repeat the check at renewal, because networks move.
Timing
Open enrollment runs once a year, and most people sign up then. A qualifying life event opens a special window at other times. A job loss, a move, a marriage, or a new baby all count. The window is limited, so act when the event happens.
Medi-Cal may be the right answer
Medi-Cal serves California households with lower income. If you qualify, it usually beats a marketplace plan on cost. Households are often split, with some members on Medi-Cal and others on a subsidized plan. We sort out who belongs where and help with the application, at no cost to you.
How we work with Angelenos
Our agents work in English and Spanish, so the explanation lands in a language you trust. Most of the work is done by phone, video, and email. Our only office is in Orange, and we keep no staff in Los Angeles. That has never been a problem for an application.
We are independent and compare plans across the carriers we represent. We do not sell every plan available in the county. We have served Southern California since 1987, and Mark L Brandenburger holds California license #0718082. Start with individual and family coverage, or see how we work. Our multilingual help page lists the languages we cover. If you are close to 65, read Medicare in Los Angeles. Or simply contact us.
Health insurance options for Los Angeles residents
Why Los Angeles residents work with us
- Licensed agents who work with you in English or Spanish.
- 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.