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Medical Insurance in California: An Overview

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Medical Insurance in California

Medical Insurance in California

Introduction: As per a survey conducted between 2001 and 2003, by the Center for Disease Control, each year 18.7% of the total California residents did not get health insurance coverage. Below, we have provided comprehensive and useful abstract describing different aspects of California's state-regulated health insurance as well as alternative health insurance options along with the products and services offered by them. Being a California dweller, you can certainly make use of this abstract.

Some Important Regulations for California Health Insurance Companies

The state government regulations to regulate the health insurance companies in California are as follows:

  • California health insurance providers must to keep a guaranteed provision for renewal; so that each and every customer can renew their respective insurance plan. However, the individuals should possess a clean record of regular and on-time premium payments. In addition, entire information provided by them, should be 100% authentic. The providers are prohibited to deny coverage renewal; on the basis of medical condition.
  • California health insurance providers can impose a waiting period for pre-existing medical conditions. Nevertheless, the duration of the waiting period depends on the number of people belongs to that California health insurance plan. Under certain circumstances, the period of time the individual was covered under prior insurance plan may be deducted from the waiting period of the new policy.
  • California health insurance providers must include dependants, newborns, future dependants and adopted children to their parent's health insurance plans; for up to 31 days. However, this rule is applicable for policies that offer coverage to dependants. According to the rule, the handicapped children can enjoy this facility; even if they exceed the specific age limit.
  • California health insurance providers can however raise or deny the cost of insurance coverage on the basis of health status of the respective individual.

Along with health insurance companies that provide permanent health coverage, you will also find some companies that offer temporary health coverage.

California Health Insurance Alternatives

Being a resident of CA, you'll find so many alternative health insurance options available in your state; provided you are not eligible for personal California health insurance plans. The list of options as well as alternative health insurance services may include:

  • California MediCal Program: This program is basically the state Medicaid program. You can avail facility of this program; if you meet the income-eligibility as well as other qualifying criteria.
  • California Major Medical Insurance Program: This program is considered as the state's high-risk medical pool. You are entitled to make use of this program; if you qualify as an “uninsurable” under most of the California health insurance policies; for chronic health condition.
  • California Department of Managed Care: This department is created to handle the unwanted issues with state-supervised health insurance plans.
  • Access for Infants and Mothers Program (AIM): This program is especially created for the women who are able to disburse a reduced premium rate for their respective health insurance plan. Mostly, the women belong to any of low and moderate income groups, can opt for this program.
  • Healthy Families: This is California's State Children's Health Insurance Program (SCHIP). Children below 19 years are the target customers of this program. Nevertheless, children from family units that are not qualified for Medicaid and unable to pay for California health insurance are only eligible for Healthy Families.

California Department of Insurance regulates California health insurance; while California's Health Maintenance Organizations (HMOs) get regulated by the California Department of Managed Health Care.

For more and in-depth information on the state's health insurance products and services, you can contact at the following address:

California Department of Insurance

Consumer Service Division
300 South Spring Street, South Tower
Los Angeles, CA 90013
800-927-HELP (4357)
Phone: 213-897-8921


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