People in San Diego arrive at this question from a few directions. Some have left a job. Some are self employed. Some are stepping off TRICARE and need civilian coverage for the first time. The mechanics are the same for all of them, and this page lays them out.
How buying your own plan actually goes
Five steps, in order
- 01
Work out your household
Count who needs covering and estimate your income for the year. Those two numbers decide whether you get help with the monthly cost.
- 02
Pick a network type
HMO, PPO, or EPO. This decides which doctors you may use, so it carries more weight than the price tag.
- 03
Pick a tier
Bronze, silver, gold, or platinum. The tier only splits costs between your monthly payment and what you pay at the clinic.
- 04
Verify your own doctors
Look up every doctor and facility you use in that exact plan directory. Do the same for your prescriptions.
- 05
Enroll and keep the file open
We submit it, confirm the start date, and stay on the case through renewals.
Why the network decides it
An HMO puts you in one network with a primary doctor who refers you onward. The monthly cost is usually gentler. A PPO lets you self refer and pays something outside the network, for more each month. An EPO usually skips referrals but pays nothing outside its network. Read up on HMO and PPO plans if you want the long version.
San Diego County has its own approved plan menu. That menu is not the one in Los Angeles County or Riverside County. Inside the county you have room to move. Chula Vista, National City, and El Cajon draw from the same county list you do. A move out of the county is a different story, and it is also a qualifying life event.
Subsidies, without numbers
Help with the monthly cost comes through Covered California only. It is set by the income you expect for the year and by your household size. We quote no figure here, because it would be wrong for most readers. We can run it with you in minutes. You can also check it at coveredca.com. We are a private agency and not a government entity.
Coming off TRICARE
Losing TRICARE opens a special enrollment window. That matters, because it means you are not stuck waiting for open enrollment. The gap is what hurts people, so start before the last day of coverage. We handle this transition often and can line the dates up.
If money is tight, look at Medi-Cal first
Medi-Cal is for California households with lower income, and it is often the right answer instead of a marketplace plan. Children frequently qualify when the adults do not. Medi-Cal also accepts applications all year, not just in one window. We check both programs and apply for whichever fits, at no cost to you.
Enrollment timing
- Open enrollment happens once a year, and anyone can switch then.
- A job loss, a move, a marriage, a divorce, or a birth opens a special window.
- Losing TRICARE or any other coverage counts as well.
- Special windows are short, so tell us the date the change takes effect.
Working with us from San Diego
Our office is in Orange, not San Diego, so we work with you by phone and video. Applications, directory checks, and renewals all go fine that way. We compare plans across the carriers we represent, and we do not offer every plan sold here. Our help costs you nothing. We have served Southern California since 1987, and Mark L Brandenburger holds California license #0718082.
Whether your ZIP code is 92103, 92104, or another in the city, the plan list is pulled for that exact ZIP. Ready to start? See our process or contact us. Turning 65 soon? Read Medicare in San Diego.
Health insurance options for San Diego residents
Why San Diego residents work with us
- Specialized in TRICARE-to-Medicare transitions.
- 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.