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"My name is Diane Le Montre, License # 0D18343, your California Health Insurance Specialist with more than 25 years experience Let me guide you through the maze of obtaining proper coverage. My services are FREE!"
Should you have any questions, please call 760-323-3939
"Get Instant, Online, Individual & Group Health Coverage Quotes from these Major California Health Care Companies."
Applications may be mailed to: Diane Le Montre P.O. Box 1102 Rancho Mirage, CA 92270
Do we have the best prices? YES! Can you buy these health plans cheaper anywhere else?? NO!
Health insurance premiums are filed with and regulated by the California Department of Insurance. Whether you order through CAHealthInsuranceAgent.com or any other agent, you'll pay exactly the same monthly premium for the same plan. This means that you can enjoy the advantages and convenience of online ordering by purchasing your health insurance plan via CAHealthInsuranceAgent.com along with the availability of personalized service and rest assured that you're getting the best available price.
TONIK IS AN AFFORDABLE ANTHEM BLUE CROSS HEALTH PLAN Apply here now for fast 15 min Online Approval directly from underwriting if qualified Click on the TONIK LOGO for Coverage
Shopping online for health coverage has never been easier. Completing your application online is a snap.
Have you heard about TONIK, the health insurance plans? These three Individual PPO plans are simple and straight-up – giving you the benefits you need without making you pay for things you don’t want.
A Tonik plan covers you for the everyday, preventive stuff (like checkups) and the more dramatic encounters (like, dare we say, knee surgery). And the application is quick and easy – it’s all online and only takes about 15 minutes. Tonik does not include maternity coverage.
Tonik plans are offered by Anthem Blue Cross.
Anthem Blue Cross has been covering A-Zs all across California for over 65 years, so you get to use their huge network of doctors and hospitals – and lots of other perks.
Tonik plans include immediate coverage for:
� Doctor visits – you pay just $20, $30 or $40 to see a doctor, depending on the plan you pick
� Generic prescription drugs – your copay is only $10
� Emergency room care
� Dentist appointments
� Eye exams, glasses or contacts
They made the rates painless, too. If you’re 19-29 years old, rates can be as low as $78 per month, depending on the plan you pick, where you live, your age and your medical history.*
If you want reliable, essential protection at some of our lowest monthly rates, SmartSense could be the health plan you’re looking for.
What makes SmartSense so smart is how it balances solid health coverage with opportunities to save money, including:
A wide range of annual deductible/monthly rate combinations. Just choose the one that fits your budget.
Lower rates on services when you use our network of more than 50,000 doctors and 400 hospitals. This means your share of medical costs will be lower, too.
Immediate benefits for your first three in-network doctor visits. You’ll just have copays with no deductible to meet. A choice of prescription drug benefits (brand-name and generic drugs, or (generics only). This helps keep your out-of-pocket prescription costs to a minimum.
Health and wellness programs. The healthier you are, the more you’ll save on health care.
Out-of-state coverage. This protects you from the high cost of unexpected emergencies when you travel.
Applying Here Online is simple and provides maximum flexibility. You may begin the application and save it at any point in the process and return later to complete it. Once you have completed your application you can come back and check on its status at anytime.
SmartSense benefits at-a-glance These amounts show your share of costs after deductibles, if any.
Plan Benefit In-Network Receive negotiated savings Out-of-network Pay higher costs Lifetime Maximum (combined for in and out-of-network) Health plan pays up to $7,000,000 per member Health plan pays up to $7,000,000 per member Annual Deductible Choices (not combined for in and out-of-network) Single member: $500/$1,500/$2,500/$5,000 Family maximum1: $1,000/$3,000/$5,000/$10,000 Single member: $5,000 Family maximum: $10,000 Annual Out-of-Pocket Maximum2 (in addition to deductible; not combined for in- and out-of-network) Single member: $2,500 Family maximum: $5,000 Single member: $10,000 Family maximum: $20,000 Doctors’ Office Visits $30 copay for first three visits3 per member per year (deductible waived); after three visits and once deductible is met, then 30% of negotiated fee 50% of negotiated fee plus all excess charges
Professional Services (x-ray, lab, anesthesia, surgeon, etc.) 30% of negotiated fee 50% of negotiated fee plus all excess charges
Hospital Inpatient (overnight hospital stays) 30% of negotiated fee All charges except $650 per day
Hospital Outpatient (if you don’t stay overnight) 30% of negotiated fee All charges except $380 per day
Emergency Room Services4 30% of negotiated fee 50% of customary and reasonable fees plus all excess charges
Maternity Not covered Not covered Preventive Care Annual physical exam(s): 30% of negotiated fee
Routine mammogram, Pap and PSA tests5: 30% of negotiated fee
Well Baby and Well Child (through age 6): 30% of negotiated fee
Annual physical exam(s): 50% of negotiated fee plus all excess charges
Routine mammogram, Pap and PSA tests5: 50% of negotiated fee plus all excess charges
Well Baby and Well Child (through age 6): 50% of negotiated fee plus all excess charges
Ambulance 30% of negotiated fee 50% of negotiated fee plus all excess charges
Physical/Occupational/Speech Therapy; Chiropractic Services 30% of negotiated fee Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropractic services 50% of negotiated fee plus all excess charges Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropractic services
Prescription Drug Coverage Options In-Network Receive negotiated savings
Out-of-network Pay higher costs
SmartSense with Generic Prescription Drug CoverageGeneric (drugs on Generic Rx formulary only) Generic: $15 copay (or 40%, whichever is greater)
Generic: $15 copay (or 40%, whichever is greater)
SmartSense with Comprehensive Prescription Drug Coverage (Anthem Blue Cross Formulary Drugs)
Generic: $15 copay (or 40%, whichever is greater)
$500 annual brand-name/specialty drug deductible (2-member maximum) applies before the following: Brand-name6: $15 copay (or 40%, whichever is greater7); 40% of negotiated fee for self-administered injectables, except insulin Specialty8: 40% $4,500 annual out-of-pocket maximum (the most you will have to pay) (In-network only and in addition to brand-name/specialty drug deductible)9
Generic: $15 copay (or 40%, whichever is greater) $500 annual brand-name/specialty drug deductible applies before the following: Brand-name6: $15 copay (or 40%, whichever is greater7); 40% of negotiated fee for self-administered injectables, except insulin Specialty: Not
You may also contact me for more information and free advice. I’ll be glad to answer any questions you may have. Just click here for a “Free Quote” and I will contact you directly to help evaluate the right plan for your individual needs.
Dental Practice Locations: 66000 Membership Fee Individual: $99.95 per year
Family: $149.95 per year
This dental network provides participants with discounts of 15% to 50%* on dental procedures at over 66,000** available dental practice locations nationwide. Participants simply present their ID card for immediate savings at the time services are rendered.
*Anticipated national average dental charges for the 2006 calendar year based on the comparison of provider negotiated fees to national average charges. Actual costs and savings vary by provider and geographical area.
**According to the Aetna Enterprise Provider Database as of March 1, 2006.
Discount plans are discount programs, and are not health insurance policies. Discount plans are designed to provide consumers access to dental networks at reduced rates. Consumers pay a membership fee in exchange for negotiated discounts on most dental services within the participating network of providers and are responsible to pay for all dental care service fees.
We also quote Life Insurance, Dental Insurance, Short Term Health Insurance, Group Health Insurance and Long Term Care
My name is Diane Le Montre, License # 0D18343, your California Health Insurance Specialist with more than 25 years experience, approving health insurance claims on behalf of several major health insurance companies, working for third party administrators handling the insurance needs for the employees of many large corporations and as a health insurance advocate for individuals.
I represent only the finest, most dependable companies in the business. You can reach them directly from this site by clicking on their logo. You will reach my site link with them and if you know the plan you require it can be applied for directly into their underwriting department and I will be your agent of record to contact should issues arise.
"My goal is to help our California clients, individuals, families and small business people obtain the very best coverage at the lowest possible prices. We know from experience working for major insurance companies and individuals acting as personal “Health Insurance Advocates” exactly how critical responsible coverage is. The cheapest is not always the best and we will explain to you in clear terms exactly why. We only represent the major California health care plans of companies who have contracted with the very best doctors and hospitals."
“My knowledge and service is not an added cost to you in any way”
YOUR HEALTH IS UNPREDICTABLE!
DON’T END UP IN COUNTY HOSPITAL!
Lack of Insurance Coverage Can Be Hazardous to your financial future.
Apply For Your Health Care Plan RIGHT HERE TODAY!
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“Not having health insurance coverage can wipe out your bank and savings accounts while leaving you with nothing but bills to pay”
Apply for your Anthem Blue Cross health care plan, Blue Shield, HealthNet of California, PacifiCare or Aetna health insurance policy online right here. When doing so you are reaching directly into their “Underwriting Department.” From THIS site you may obtain the most rapid approval possible.
Plan Types
There are several different types of managed-care health insurance plans. These include HMO, PPO, POS & HSA plans. Managed-care plans typically make use of healthcare provider networks. Healthcare providers within a network agree to perform services for managed-care plan patients at pre-negotiated rates and will usually submit the claim to the insurance company for you. In general, you'll have less paperwork and lower out-of-pocket costs with a managed care health insurance plan and a broader choice of healthcare providers with an indemnity plan.
What is a PPO plan?
As a member of a PPO (Preferred Provider Organization) plan, you'll be encouraged to use the insurance company's network of preferred doctors and hospitals. These healthcare providers have been contracted to provide services to the health insurance plan's members at a discounted rate. Typically you won't be required to pick a primary care physician but will be able to see doctors and specialists within the network at your own discretion. You will probably have an annual deductible to pay before the insurance company starts covering your medical bills. You may also have a co-payment for certain services or be required to cover a certain percentage of the total charges for your medical bills. With a PPO plan, services rendered by an out-of-network physician are usually covered at a lower percentage than services rendered by a network physician. What is an HMO plan?
What is an HMO plan?
Though there are many variations, HMO (Health Maintenance Organizations) plans as a rule enable members to have lower out-of-pocket healthcare expenses but also offer less flexibility in the choice of physicians or hospital than other health insurance plans. As a member of an HMO, you'll be required to choose a primary care physician (PCP). Your PCP will take care of most of your healthcare needs. Before you can see a specialist, you'll need to obtain a referral from your PCP. With an HMO you'll likely have coverage for a broader range of preventive healthcare services than you would through another type of plan. You may not be required to pay a deductible before coverage starts and your co-payments will likely be minimal. With an HMO plan, you usually won't have to submit any of your own claims to the insurance company. However, keep in mind that you'll likely have no coverage whatsoever for services rendered by non-network providers or for services rendered without a proper referral from your PCP.
What is a POS plan?
A POS (Point of Service) plan combines some of the features offered by HMO and PPO plans. As with an HMO, members of a POS plan are required to choose a primary care physician (PCP) from the plan's network of providers. Services rendered by your PCP are most often not subject to a deductible. Also, like HMOs, POS plans typically offer coverage for preventive care visits. Typically, however, you will only receive a higher level of coverage for services rendered or referred by your PCP. Services rendered by a non-network provider may be subject to a deductible and will likely be covered at a lower level. If services are rendered outside of the network, you'll likely have to pay up-front and submit a claim to the insurance company yourself.
What is an HSA?
Legislation establishing Health Savings Accounts (or "HSAs") took effect on January 1, 2004. HSAs and HSA-eligible health insurance plans are becoming more and more popular. Here are the basics: ? An HSA is a tax-favored savings account that may be used in conjunction with an HSA-eligible high deductible health insurance plan to pay for qualifying medical expenses. ? Choosing an HSA-eligible health insurance plan may help you save money. As a rule, the monthly premium on an HSA-eligible high deductible plan is less expensive than the monthly premium for a lower-deductible health insurance plan. ? Contributions to an HSA may be made pre-tax, up to certain annual limits. ? Funds in the HSA may be invested at your discretion. Unused funds remain in the account and accrue interest year-to-year, tax-free. Not all high-deductible plans are eligible for use in conjunction with an HSA.
What is an Indemnity plan?
A traditional Indemnity plan offers a great deal of freedom in choosing which doctors and hospitals to use, but will probably involve higher out-of-pocket costs and more paperwork. Under an Indemnity plan, you may see whatever doctors or specialists you like, with no referrals required. Though you may choose to get the majority of your basic care from a single doctor, your insurance company will not require you to choose a primary care physician. However, this kind of freedom will cost you. You'll likely be required to pay an annual deductible before the insurance company begins to pay on your claims. Once your deductible has been met, the insurance company will typically pay your claims at a set percentage of the "usual, customary and reasonable (UCR) rate" for the service. The UCR rate is the amount that healthcare providers in your area typically charge for any given service. An Indemnity plan may also require that you pay up front for services and then submit a claim to the insurance company for reimbursement.
When will my coverage start?
You can request that your Individual and Family health insurance plan start anytime between 1 and 90 days in the future. However, the insurance companies will typically need some time to process your application so keep in mind that the actual date for the start of your coverage may vary depending on the underwriting process and the availability of your medical records.
Will using this service cost me anything?
All the services offered by CaliforniaHealthInsuranceAgent.com are provided at no extra cost to you, the consumer. If you buy a health insurance plan via CAHealthInsuranceAgent.com, you'll pay the regular monthly premium to the health insurance company you chose, but you'll pay nothing to us. Our fees are paid by the insurance companies in the form of commissions, which are built into the premium amount.
Do you have the best prices?
Health insurance premiums are filed with and regulated by the California Department of Insurance. Whether you order through CAHealthInsuranceAgent.com or another local agent, you'll pay the same monthly premium for the same plan. This means that you can enjoy the advantages and convenience of online ordering by purchasing your health insurance plan via CAHealthInsuranceAgent.com along with the availability of personalized service and rest assured that you're getting the best available price.
A wide range of annual deductible/monthly rate combinations. Just choose the one that fits your budget. 
