Before you shop for a health plan in San Bernardino, settle one thing. Work out which program your household belongs in. Get that wrong and you can spend money you never needed to spend. This page walks through individual and family coverage, program by program.
Medi-Cal comes first in the order of questions
Medi-Cal is the state program for lower income households. Members pay very little toward it, and there is no closed season, so you can apply at any point in the year. Eligibility turns on household income and household size. If your family qualifies, buying a marketplace plan instead would be money thrown away.
Mixed households are ordinary here, not unusual. Children can be on Medi-Cal while a parent carries a marketplace plan. An adult child at home may sit in a different place again. We sort each person separately and keep the paperwork aligned.
If Medi-Cal is not the answer
Then you are looking at two routes. Covered California is the state marketplace, and the only place income based help lowers your monthly cost. The other route is buying straight from a carrier, which carries no income help. We can place either, and we are a private agency rather than a government entity.
That income based help depends on what your household expects to earn for the plan year and how many people are counted in it. We publish no amounts on this page, since the thresholds get revised. Verify your own position at coveredca.com, or let a licensed agent run the projection alongside you.
Reading the metal tiers
- Bronze keeps the monthly cost light and leaves more to pay at the point of care.
- Silver is the middle tier, and extra cost sharing help is tied only to it.
- Gold raises the monthly cost and eases what you pay when you get care.
- Platinum carries the highest monthly cost and asks the least of you at the clinic.
The essential benefits are the same in every tier. The tier only moves the timing of the money.
The network question
What each network type does to your access
HMO
One primary doctor coordinates everything and writes referrals to specialists. The network is narrower and the monthly cost is often lighter. Nothing outside the network is paid, apart from an emergency.
PPO
You go to specialists directly, with no referral needed. Out of network care still gets some payment, though your share grows. The monthly cost is higher for that reach.
EPO
Self referral inside the network and nothing outside it beyond emergencies. It usually prices between the other two.
Most households make this decision on one name. If a particular doctor or clinic has to stay reachable, that fact chooses the plan for you. Our individual and family page sets out the comparison in more depth.
Bring us this and the rest gets easy
- The names of every doctor and specialist the household sees.
- Any medicine taken regularly, plus the pharmacy filling it.
- A realistic picture of household income for the coming plan year.
- Your ZIP code, since the plan menu and the network both follow your address.
County and ZIP code shape the menu
San Bernardino is the seat of San Bernardino County, and marketplace menus are approved region by region. Colton and Redlands sit in the same county and shop the same shelf you do. A household in 92404 and one in 92410 therefore see the same lineup. Cross out of the county and the menu is approved separately, so a move can change what you may buy.
Timing
Marketplace coverage has a single open enrollment period each year, from autumn into winter. Outside it, a qualifying life event is what opens the door. Losing a job and the coverage attached to it is one. A move, a marriage, a birth, or an adoption all count. The window after an event is short, so make the call early.
Three things to hold on to
Ask about Medi-Cal before you spend anything. Confirm your doctors inside the plan network before you enroll, not after. Plan availability and benefits vary by plan and by area and can change, so have a licensed agent review your own case each year.
Working with us from the county seat
Video and phone carry nearly all of our work with San Bernardino households. On video we share a screen, cut the list down, and you see every step of it. On the phone we do the same without the screen. Our one office is in Orange, a long drive from here. It is open when a meeting in person is the right call.
Harmony SoCal Insurance Services was founded in 2015 and holds California license #0718082. Our help carries no fee for you. Call (714) 922-0043 or read the San Bernardino overview.
Health insurance options for San Bernardino residents
Why San Bernardino residents work with us
- Community enrollment events.
- Independent - we represent 20+ carriers, not one.
- Bilingual English + Spanish daily; Korean, Mandarin, Vietnamese available.
- Same agent year-over-year - no call-center rotation.