I've bought my own health insurance for the past 20 years, since I was self employed. Until Obamacare, I had a catastrophic policy with Blue Shield. Once we switched to Covered CA I got the Silver Plan with Health Net. Although I have been perfectly healthy my whole life, I did use the insurance twice: once for my bike accident last Fall, and again for my recent bilateral hip replacement.
I really studied the plans, and it has worked for me financially. With Health Net, I paid $108. a month, because I qualified for a subsidy. My out of pocket expense for an ambulance trip, MRI, and a few hours in the emergency room was only $1,000. I stopped them when they wanted to do more xrays. I explained that I didn't know how much Health Net would cover. You don't have to do everything they say. The doctor agreed with me (quietly, and in private,) and he released me.
For my hip replacements, I chose a surgeon who doesn't bill through insurance. He is very famous, and is booked for months is advance. I changed my insurance over from Health Net to Blue Shield. (You have to have a life change to be able to switch. I had a change in income.) Blue Shield covered the hospital and rest of the visit. My bills totalled about $21,000. $13,000 of that was for the surgeon. He charges $6,500 per hip. I will receive a reimbursement check from Blue Shield for between $1,000.-$13,000. In October, I will go back to a less expensive plan. When I see my surgeon a year from my surgery date, I will pay him cash. It will still be cheaper. He told me that they don't do much at that visit, so it shouldn't cost much. It will still be less than staying with the PPO that I got in August. The PPO is $439. a month. I only had to pay that for part of the year.
While in the hospital, I refused the sleeping pills, Benadryl, and other medications that I didn't need. I bought used crutches at the Salvation Army. I used my mom's walker. I told them I would buy a cane, but I didn't need one. I didn't need the crutches, either. I also didn't need a refill of the prescriptions. I only used about half. I switched over to Motrin.
There's a lot you can do with planning and research. Hip replacements are very expensive. I feel like the system worked very well for me. It was worth it to me to pay cash for Dr. Matta. His testimonials all say the same thing.