California Health Insurance

California Health Insurance Options

In addition to regular health insurance plans, California has several plan options that are unique to the state. These California health insurance options include:

Healthy Families

Healthy Families is a low cost California health insurance plan that provides health, dental, and vision coverage to children under the age of 19. In addition to paying for visits to doctors, dentists, and specialists, the plan also contracts with clinics, laboratories, pharmacies, and hospitals. (See the Summary of Benefits.)

To qualify for this California health insurance plan, children must be:

• Under the age of 19
• Living in California
• Ineligible for Medi-Cal
• A U.S. citizen or meet immigration rules
• In a family without employer-sponsored health insurance
• In a family with incomes within the Healthy Family Guidelines

Because Healthy Families does not deny coverage to children who have an existing medical condition, a medical exam is not necessary to become enrolled in the plan. Once enrolled, children are eligible for all covered services that are medically necessary.

The monthly premium for this California health insurance plan is determines by income and family size. Premiums also depend on which Healthy Families plan among several that you choose. The minimum premium is $4 per child, and the maximum is $15. No matter how many children are in the family, the most a family will ever be required to pay is $45 per month.

To enroll in the Health Families plan, visit the Healthy Families website.

California Major Medical Insurance Plan

The California Major Medical Insurance Plan (MRMIP) first became operational in 1991 and provides health insurance for California residents who are not eligible for traditional individual health plans. MRMIP is funded by the state and subscriber premiums. To be eligible for this California health insurance plan, participants must be:

• Living in California
• Ineligible for Parts A and B of Medicare
• Ineligible for COBRA or CalCOBRA benefits
• Able to prove that they are unable to secure adequate health insurance coverage

After being enrolled in this California health insurance plan for three years, participants are granted “guaranteed eligibility” for individual health insurance plans and can become enrolled in guaranteed-issue coverage.

Premiums vary depending on which one of the four MRMIP plans you choose. Generally, you will pay anywhere from 25 to 37.5 percent more for MRMIP than you would for a private health insurance plan. You will also be required to pay co-pays in addition to your premiums. However, there are no deductibles, and there is a maximum annual out of pocket cap of $2,500 for an individual and $4,000 for a family.

To enroll in MRMIP, visit the official MRMIP website.

Medi-Cal

The California name for the federal Medicaid program is Medi-Cal. This California health insurance plan provides health insurance to low-income people who meet specific eligibility requirements. It is possible to receive both Medi-Cal and Medicare to pay for your medical expenses. In most cases, Medi-Cal covers physician visits, X-ray and laboratory tests, hospital and nursing home care, adult day health services, home health care, and some prescription costs. Medi-Cal may also cover some dental care, prosthetic and orthopedic devices, eyeglasses, hearing aids, medical equipment, ambulance services, and hospice care. To be eligible for this California health insurance plan, participants must be:

• Blind
• 65 or older
• Younger than 65 with a disability

There are many other ways to qualify for Medi-Cal coverage. To find more detailed information, visit HealthConsumer.org.

The premiums for Medi-Cal vary depending upon your income level and the other programs that you are involved in. If you think you qualify for Medi-Cal, you can apply for coverage at your local Social Security Office. You can also visit Medi-Cal online at Medi-Cal.ca.gov.

Purchase Medical Insurance

Plenty of health insurance companies offer medical insurance throughout the state of California. Although many residents obtain health insurance through their employers, individual coverage is available for self-employed people and people who do not receive adequate coverage through work.

• Blue Shield of California offers coverage for both group and individual plans. This reputable company offers coverage plans for people who:
  • Want to utilize a Health Savings Plan (HSA)
  • Prefer enrollment in an HMO
  • Prefer enrollment in a PPO
  • Need vision and dental coverage

Local agents are available throughout California, or potential applicants can find out more information online.

• Blue Cross of California provides a wide variety of health insurance products to a large number of residents. Various offerings from this prevalent company include:
  • Medicare supplemental coverage
  • HMO programs for federal employees
  • Individual health plans
  • Coverage for both small and large businesses

Blue Cross agents are available online, over the phone, or at any of the many local offices throughout the state.

• Cigna offers health insurance plans to California residents. This company is a national provider but has specific plans for Californians:
  • Health insurance coverage for Californian labor unions
  • Health insurance coverage for state employees
  • Special discounts programs for wellness products and services

Cigna has operated within the state for several years and is regarded as a reputable insurance provider.

If you are shopping for the best health insurance rates in California you may want to consider utilizing the services of an insurance comparison website. These websites find several Californian providers and show you the lowest rates based on your needs. Examples of insurance comparison websites include Abrams California Health Insurance Agency and eHealth. Remember that although these websites can be great tools when shopping for health insurance within California, the sites do not have an exhaustive list of every provider.