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California Health Insurance (CA)


Despite the fact that California has the second highest amount of uninsured children in the U.S. (slightly behind Texas), the state of California still ranks high in the Agency for Healthcare Research and Quality list.

California is especially exceptional in its home health care and pain management quality. It still needs improvement in smoking cessation counseling after a heart attack, as well as the quality of nursing home care and treatment.

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California Individual Health Insurance (CA)

Individual health policies have different rules. You can be denied insurance coverage due to a health problem (unless you are eligible with HIPAA) and there are no limits on the premium price. HIPAA eligible people cannot be turned down for individual insurance, cannot be given pre-existing condition exclusion periods, and have limitations on the cost of the insurance. According to the California Department of Insurance, if you have been covered with an individual or group policy and have had no breaks in coverage of more than 62 days, you must be given creditable coverage for the prior insurance by the new insurance company. Individual insurance cannot be cancelled if you get sick.

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California State Insurance Programs (CA)

The Major Risk Medical Insurance Program is available for a period of 36 months to those who cannot afford individual health insurance due to a pre-existing condition. After 36 months are over, an individual health insurance policy is guaranteed to you, with limits on its cost and without exclusions for your pre-existing condition.

For those with limited incomes, the Medi-Cal program is available to give you assistance. Also, if you do not have health insurance for your family, and your children are age 18 or younger, with certain provisions, you can buy Healthy Families program insurance. With eligibility, Access for Infants and Mothers may also be available to some middle-income mothers and infants.

California Self-Employed Health Insurance (CA)

A self-employed person is not allowed to buy group health insurance in the State of California.

California Group Health Insurance (CA)

In California, group health insurance cannot be refused because of a health problem. You will not be required to pay extra, provided you qualify. Group health insurance cannot be cancelled if you get sick. If you have pre-existing conditions and a change in jobs, you cannot be denied group insurance at a new job. Although, you may have limited time if the problem is excluded from insurance coverage. If you do not have a long break (63 days or more) in prior health coverage, you will be eligible for creditable coverage.

Insurance companies can only review the six months before new coverage for any pre-existing conditions. In addition, they cannot count genetic information as a pre-existing condition. HMOs can require a limited waiting time, called an affiliation period. Conversion policies are always available on an individual basis to those who had group insurance for at least three months and then lost it for prescribed reasons. There are additional rights allowed for pregnant women in California.

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California Small Business Health Insurance (CA)

A small business cannot be turned down for health insurance due to any factors, health or otherwise, in the group of employees. However, if someone in the group is ill, the insurance company is allowed to charge a higher premium for group coverage. The state allows a small business (two to 50 employees) or a business of any size to purchase group health insurance through a qualified, statewide alliance or trade association. It is recommended that you contact the California Department of Insurance about joining associations for the purpose of attaining group health insurance.

California Department of Insurance
300 Capitol Mall, Suite 1700
Sacramento, CA 95814
(800) 927-HELP
(213) 897-8921
www.insurance.ca.gov/docs/index.html


Health Insurance in California Cities (CA)

Learn more about health insurance (including medical facility details) in Anaheim, Berkeley, Burbank, Carlsbad, East Bay, Fremont, Huntington Beach, Irvine, Long Beach, Los Angeles, North Bay, Oakland, Orange County, Pasadena, Pomona, Sacramento, Salinas, San Bernardino, San Diego, San Francisco, the SF Bay Area, San Jose, San Rafael, Santa Cruz, Santa Monica, Santa Rosa, South Bay, Torrance and Ventura.

 

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