2025 Health Insurance in California: Key Changes, Rates, and Enrollment Periods

Navigating Your Health Insurance Options for 2025

As we approach the last quarter of 2024, we’re excited to help our clients secure the best health insurance options for the coming year. Covered California’s Renewal Season kicks off on October 1st, and we’re here to guide you in finding the coverage that fits your needs.

This is an important time for individual health insurance policyholders to renew their current plans and update their personal and income information. It’s a great opportunity to check if your current plan still meets your healthcare needs and budget for 2025 or if adjustments are necessary. If you choose not to make any changes, your current health plan will automatically renew starting November 4th, 2024, keeping the same coverage with the adjusted 2025 premiums, effective January 2025.

Key Dates to Remember

Renewal Season: Starts October 1st, 2024.

Automatic Renewals: Begin on November 4th, 2024, for those not making changes.

Open Enrollment Period: Runs from November 1st, 2024, to January 31st, 2025.

During the Open Enrollment Period, you can switch health insurance carriers or move between Covered California (on-exchange) and off-exchange plans. This window is crucial if you want to change your coverage or explore new plans that might better suit your needs.

2025 Updates and Changes
Covered California has worked hard to keep the 2025 rate increase at a moderate average of 7.9%, which is relatively stable compared to last year. Additionally, funds collected from the penalty for not carrying health insurance in California will now be used to enhance all Silver plans for those who allow Covered California to e-verify their income and immigration status.

These plans will now have the benefits of the Silver 73 plan, including a $0 deductible and a maximum out-of-pocket cost of $6,100. Anyone on the Silver plan who allows an e-verifying will be migrated automatically to the Silver 73 plan. This welcome benefit improvement will provide excellent financial protection for many Californians. The benefits of the Silver 70 for Californians who did not request subsidies and did not share income information will remain the same s of 2024 . The Benefits of the Silver 87 and Silver 94 remain unchanged.

Bronze Plan Enhancements

Deductible Reduction: Now $5,800 (down from $6,300).

Pharmacy Deductible: Reduced from $500 to $450.

Out Of Pocket Maximum: Reduced from $9100 to $ 8,850 for an individual

Unlimited Doctor Visits: You can now access primary care doctors and urgent care visits without first meeting the deductible.

Specialist Visits: The first three visits are covered with Co-payments of $95 without applying the deductible; additional visits will be subject to the $5,800 deductible.

Rising Popularity of HMO Plans
The expectations are, as we look ahead to 2025, HMO plans will continue to gain popularity. They typically offer lower premiums and out-of-pocket costs but require using a network of primary doctors and hospitals. The primary doctor is the gate keeper of your health and will refer you to a specialist when he/she feels it it necessary for health .

Regional Rate Changes for 2025

Los Angeles: 7% increase (weighted average).

Riverside: 5.3% increase.

Orange County: 9.6% increase.

San Diego: 8.1% increase.

Northern California: Higher increases, ranging from 7.7% to 15.7%, depending on the region.
Remember, switching health plans can help offset these increases.