Presented By: Miranda Cruz License# 0J22743
Medical Benefit Comparison
CaliforniaChoice
CaliforniaChoice
CaliforniaChoice
CaliforniaChoice
Medical
Silver HMO A Kaiser Permanente - Full
Silver HMO A Health Net - WholeCare Bronze HMO A Kaiser Permanente - Full
Platinum HMO A Kaiser Permanente - Full
Effective Date: 1/1/2026
Effective Date: 1/1/2026
Effective Date: 1/1/2026
Effective Date: 1/1/2026
DEDUCTIBLE
Individual
HMO: $2,300
HMO: $0 HMO: $0
HMO: $5,800
HMO: $0 HMO: $0
Family
HMO: $4,600 (embedded)
HMO: $11,600 (embedded)
OUT-OF-POCKET MAX
Individual
HMO: $9,100 (includes ded)
HMO: $10,150 HMO: $20,300
HMO: $9,800 (includes ded)
HMO: $3,000 HMO: $6,000
Family
HMO: $18,200 (embedded; includes ded)
HMO: $19,600 (embedded; includes ded)
PHYSICIAN SERVICES
Office Visits
HMO: $65/$100 (ded waived)
HMO: $55/$90
HMO: $60 (ded waived)/$95 (First 3 visits ded waived)
HMO: $10/$20
Telemedicine Preventive Care
HMO: See each carrier for details
HMO: See each carrier for details
HMO: See each carrier for details
HMO: See each carrier for details
HMO: 0% (ded waived)
HMO: 0%
HMO: 0% (ded waived)
HMO: 0%
Diagnostic Lab/X-Ray Imaging (CT/PET scans, MRIs)
HMO: $45 (ded waived)/$80 after ded HMO: $400/procedure after ded
HMO: $40/$60
HMO: $50 (ded waived)/40% after ded
HMO: $20/$40
HMO: $400/procedure
HMO: 40% after ded
HMO: $150/procedure
HMO: $65 (ded waived) Rehabilitation/Habilitation (PT/OT/ST)
HMO: $55
HMO: $60 (ded waived)
HMO: $10
Chiropractic Care
HMO: $15 (ded waived; 20 visits per year)
HMO: Not Covered
HMO: Not Covered
HMO: $15 (20 visits per year)
PRESCRIPTION DRUGS Pharmacy Deductible Tier 1 (Generic Formulary) Tier 2 (Preferred Brand Formulary) Tier 3 (Non-Preferred Brand Formulary)
HMO: $500/$1,000 (Subject to Tiers 2-4)
HMO: $500/$1,000 (Subject to Tiers 2-4)
HMO: $450/$900 (Subject to Tiers 2-4)
HMO: None
HMO: $20 (up to 30 day supply) HMO: $100 (up to 30 day supply)
HMO: $20 (up to 30 day supply)
HMO: $20 (up to 30 day supply)
HMO: $5 (up to 30 day supply) HMO: $15 (up to 30 day supply)
HMO: 50% up to $250 (up to 30 day supply)
HMO: 40% up to $500 (up to 30 day supply)
HMO: $100; prior auth. required (up to 30 day supply) HMO: 20% up to $250; prior auth. required (up to 30 day supply)
HMO: 50% up to $250 (up to 30 day supply)
HMO: 40% up to $500 (up to 30 day supply)
HMO: $15 (up to 30 day supply)
Tier 4 (Specialty Drugs)
HMO: 50% up to $250; prior auth. required (up to 30 day supply)
HMO: 40% up to $500 (up to 30 day supply)
HMO: 10% up to $250; prior auth. required (up to 30 day supply)
Final rates are determined by the Carrier. This quote is not valid without the separate general disclaimer. # Dependent children 21-25 years old are rated as adults. Dependent children may become ineligible for coverage on their 26th birthday; effective date of change may vary by carrier.
Create Date: 10/31/2025
Sorted By: Carrier,PlanType,Premium(Ascending)
Presented By: Miranda Cruz License# 0J22743
Presented By: Miranda Cruz License# 0J22743
Medical Benefit Comparison
CaliforniaChoice
CaliforniaChoice
CaliforniaChoice
CaliforniaChoice
Medical
Silver HMO A Kaiser Permanente - Full
Silver HMO A Health Net - WholeCare Bronze HMO A Kaiser Permanente - Full
Platinum HMO A Kaiser Permanente - Full
Effective Date: 1/1/2026
Effective Date: 1/1/2026
Effective Date: 1/1/2026
Effective Date: 1/1/2026
Mail Order
HMO: See Formulary Guide
HMO: See Formulary Guide
HMO: See Formulary Guide
HMO: See Formulary Guide
HOSPITAL FACILITY SERVICES HMO: 45% after ded Inpatient Hospital Services
HMO: $900/day, 5 days max
HMO: 40% after ded HMO: 40% after ded
HMO: $500/admit
Outpatient Surgery in a Hospital
HMO: 45% after ded
HMO: 50%
HMO: $300/procedure
HMO: 45% after ded Ambulatory Surgical Center
HMO: 40%
HMO: 40% after ded
HMO: $300/procedure
EMERGENCY SERVICES
Emergency Room
HMO: 45% after ded (coinsurance waived if admitted)
HMO: 50%
HMO: 40% after ded
HMO: $200 (copay waived if admitted)
Emergency Transport/Ambulance
HMO: 45% after ded
HMO: 50%
HMO: 40% after ded
HMO: $150
Urgent Care
HMO: $65 (ded waived)
HMO: $55
HMO: $60 (ded waived)
HMO: $10
MENTAL HEALTH/SUBSTANCE USE DISORDER HMO: 0% (ded waived) Outpatient Services
HMO: $55
HMO: 0% (ded waived) HMO: 40% after ded
HMO: $10
Inpatient Services
HMO: 45% after ded
HMO: $900/day, 5 days max
HMO: $500/admit
MATERNITY HMO: 0% (ded waived) Prenatal and Postnatal Care
HMO: Prenatal: $55; Postnatal: $55
HMO: 0% (ded waived) HMO: 40% after ded
HMO: 0%
Delivery and All Inpatient Services
HMO: 45% after ded
HMO: $900/day, 5 days max
HMO: $500/admit
Final rates are determined by the Carrier. This quote is not valid without the separate general disclaimer. # Dependent children 21-25 years old are rated as adults. Dependent children may become ineligible for coverage on their 26th birthday; effective date of change may vary by carrier.
Create Date: 10/31/2025
Presented By: Miranda Cruz License# 0J22743
Sorted By: Carrier,PlanType,Premium(Ascending)
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