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California Health Insurance

According to the Center for Disease Control, between 2001 and 2003 an average of 18.7% of California residents per year did not have health insurance.

California Health Insurance Regulations

All California health insurance companies are required to include a guaranteed renewable provision in all health insurance plans. This means that any individual wishing to renew their health insurance plan in California is allowed to do so under state law provided the individual has not provided any false information and has paid all premiums on time.

California laws also limit the health insurance provisions dealing with pre-existing conditions in individuals. California health insurance companies can, however, implement an exclusion period for any pre-existing conditions. The length of the exclusion period is limited depending on how many people are covered under the California health insurance policy. Previous California medical insurance coverage can be credited towards this exclusion period under some conditions.

The state of California also regulates California health insurance coverage of dependents and future dependents and newborns and adopted children are automatically included under the parents’ individual insurance policy. This automatic insurance coverage remains in place for 31 days provided the insurance policy already provides coverage for dependents. Handicapped dependents, however, can still be covered under the parents’ California health insurance plan even if they are over the age limit for plan coverage.

The cost of individual California health insurance varies and can be denied or increased based on the health of the individual. However, based on the guaranteed renewability provision, California health insurance cannot be terminated based on illness. There are also some health insurance companies in California that provide temporary health insurance.

Alternative California Health Insurance Options

California has health insurance plans and programs in place to provide services for individuals who may not qualify for individual California health insurance. Such services include:

  • California Department of Managed Care is a department that has been set up to manage problems with state-regulated health plans.
  • California MediCal Program is California’s Medicaid program and is available to those that qualify the income and eligibility criteria.
  • California Major Medical Insurance Program is California’s high-risk health insurance pool. This program exists for those who might otherwise be considered “uninsurable” due to chronic illness. Pre-existing condition period may apply.
  • Healthy Families is the State Children’s Health Insurance Program that is designed to provide California health insurance coverage to children under 19 years of age. Families mush not qualify for MediCal but also must not be able to afford California health insurance.
  • Access for Infants and Mothers Program (AIM) is designed to provide inpatient and outpatient services to women of low to moderate income who pay a reduced premium.
  • Pacific Health Advantage (PacAdvantage) helps small employers of 2-50 employees afford California health insurance.

California health insurance is regulated by the California Department of Insurance where as California Health Maintenance Organizations (HMOs) are regulated by the California Department of Managed Health Care.

California Department of Insurance

California Department of Insurance:

California Department of Insurance
Consumer Services Division
300 South Spring Street, South Tower
Los Angeles, CA 90013
800-927-HELP (4357)

For other California Insurance Resources, See:

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