California Health Insurance

Health Insurance Overview

California residents have many options for health care coverage. There are numerous California insurance providers to choose from, along with a variety of California medical insurance plans designed to meet the specific needs of individuals, families and groups.

Whether you need independent self-employed health coverage, or your employer simply doesn’t offer group California health insurance benefits. Whether you are looking to cover your spouse and children under the same low rate, or you are a small business that wants to provide your employees with affordable coverage. Whatever your situation, we are your one stop resource for all your health care needs – including reliable California medical insurance from the best California insurance providers around.

Each state is unique in its laws and regulations, as well as the types of coverage it offers. Here you will find an array of resources and useful information to help you better understand California health insurance and the range of options available to you. This includes current facts and statistics about residents, important state legislation, financial assistance and public California health insurance programs, and even details on some of the top California insurance providers.

To compare specific California medical insurance plans offered by the various California insurance providers, and get a personalized quote for the options that are right for you, contact us now for free. We’ll connect you with a highly qualified insurance agent near you who will be happy to help you with all of your California health insurance needs.

At Healthcare Solutions Team, we’re committed to making affordable health care accessible to everyone. Our group of elite California health insurance advisors is dedicated to helping match the right coverage to fit the unique needs of all families, individuals and groups. Not a resident of California? Find your state here.

California Health Insurance Facts & Statistics

Total California Residents – 36,899,700

Total Health Insurance Coverage In California:
Employer – 45%
Individual – 6%
Medicaid – 19%
Medicare – 10%
Other Public – 1%
Uninsured – 19%

Average Individual Monthly Premiums – $157

Average Annual Single Employee Contribution for Employer-Based Health Insurance Plan – 22%

Average Annual Single Employee Premium for Employer-Based Health Insurance Plan – $1,048

Average adjusted hospital cost per inpatient day – $2,419

Source data according to the Kaiser Family Foundation (http://www.kff.org/) (2009-2012 data) and http://www.statehealthfacts.org/

California Medical Insurance Laws, Regulations & Policies

There are several California health insurance laws and regulations that are put in place to protect policyholders living in the state. Under state law, any HIPAA-eligible resident is guaranteed to be able to purchase a health insurance plan from any company. California insurance providers are also prohibited from requiring exclusion periods for HIPAA-eligible residents.

California health insurance law requires that private health plans cover certain medical services. These required services  include:

  • Routine care for cancer clinical trials
  • Breast, prostate and cervical cancer screenings
  • Continuity of medical care for pregnant women
  • Vaccinations
  • Some care services for residents with diabetes

In California, once a resident is accepted for coverage, their policy is guaranteed renewable and insurance companies cannot cancel their coverage if they get sick. The law also requires California insurance providers to have the same coverage limits and benefits for mental health conditions; this is known as mental health parity.

Residents who have left their employer’s group health plan are protected under the federal law COBRA. In addition, all insurance rate reductions or increases must be approved by the state’s insurance commissioner before the change goes into effect. Also, in California, group health insurance for small groups of two to 50 people is guaranteed issue.

California Health Insurance Resources

California Health Care Services

California Health Service’s Directory of Health Care Services and Programs

California Health Insurance High Risk Pool

The Patient Protection and Affordable Care Act established temporary national high risk pools to provide health insurance to people with medical conditions. The Pre-Existing Condition Insurance Plan (PCIP) in California is not a public program and enrollees will have to pay monthly premiums and out-of-pocket costs similar to regular California health insurance policies.

Enrollees in the California PCIP pay around the same amount that an individual without pre-existing conditions would pay on the private insurance market. The estimated monthly cost for California residents ranges between $127 for a 15 year old and $1,003 for a 74 year old. Enrollees must also meet a $1,500 deductible and have a $2,500 out-of-pocket limit. Residents who are eligible for the plan will get access to health insurance coverage for physician and hospital visits, emergency services, prescription drug coverage, and more.

Individuals are eligible to enroll in the California PCIP if they are a United States’ citizen, have an existing medical condition, and have been without health insurance for six months. For more information on the California health insurance high risk pool visit http://www.healthcare.gov/index.html.

To stay up-to-date on the latest health care reform news, visit: http://healthreform.kff.org/

California Medical Insurance and Health Care Programs

The state of California offers residents quite a few public health insurance programs to assist low-income residents in getting access to affordable health care and insurance coverage. These programs include:

  • Medi-Cal
    Medi-Cal is the Medicaid program in California that provides health insurance for some low-income residents. If you want to learn more about Medi-Cal, visit online. Eligibility requirements for Medi-Cal coverage can be found found here.
  • Healthy Families
    Healthy Families is the State Children’s Health Insurance Program (SCHIP) in California, designed for children under age 19 who do not qualify for Medi-Cal and cannot afford private coverage. To learn more about Healthy Families, visit the website.
  • Major Risk Medical Insurance Program (MRMIP)
    California also offers a high risk pool (MRMIP) for residents with pre-existing conditions who are unable to find health insurance through a private company. To learn more about this California medical insurance program, visit http://www.mrmib.ca.gov/.
  • Access For Infants and Mothers (AIM)
    This program provides health insurance coverage for some pregnant women who have no insurance or are underinsured. Visit http://www.aim.ca.gov/Home/default.aspx for more information.
  • Every Woman Counts
    California’s Breast and Cervical Cancer Treatment Program offers Medicaid coverage to eligible women who are diagnosed with breast or cervical cancer. The website for this California health insurance program can be found here.
  • California Medicare
    Seniors eligible for Medicare can get health insurance coverage through Medicare Advantage, Supplement and Original Medicare.

Some residents in California may also be eligible for the Federal Health Coverage Tax Credit for assistance in purchasing a plan. Visit the Internal Revenue Service (IRS) online for more information.

Universal Health Care in California
San Francisco is the only city in California that provides all uninsured residents with access to health insurance coverage. Residents earning up to 500 percent of the federal poverty level qualify for the program, “Healthy San Francisco.” Only San Francisco residents qualify for the universal coverage, and they must receive care within the city limits. Its website is at http://www.healthysanfrancisco.org/.

California Insurance Providers

Aetna Health Insurance

Aetna is one of the largest health insurance providers in America with more than 30 million members. Its network includes more than 787,000 health care professionals.

Aetna AARP Health Insurance

Aetna covers more than 30 million members and is one of the largest health insurance companies in the country. Policyholders have access to more than 787,000 doctors, hospitals and other health care providers.

Anthem Blue Cross of California Health Insurance

Since 1937, Blue Cross of California has made health care more affordable for California residents. Today, it has more than 6.8 million members.

Assurant Health Insurance

Assurant Health, headquartered in Milwaukee, has been offering quality insurance products and coverage to more than 1 million members since 1982. Assurant is committed to providing health insurance plans that have broad coverage while providing valuable protection.

Blue Shield of California Health Insurance

Since 1939, Blue Shield of California has been a leading health insurance provider. Today, it’s a non-profit company with 3.2 million members.

Celtic Health Insurance

Celtic concentrates on individual health insurance, offering a wide variety of plans for both individuals and families.

Cigna Health Insurance

CIGNA is one of the oldest insurance companies in America, providing health insurance and other coverage solutions to millions of consumers around the country.

Health Net Health Insurance

Almost 7 million Americans from coast to coast are members of Health Net. With affordable health insurance plans, policyholders get access to high-quality care.

Health Net California Health Insurance

Health Net is one of the top health insurance providers in California offering a wide array of plans for a diverse set of needs.

Health Net Farm Bureau Health Insurance

For residents of California, Nationwide provides affordable access to health care with plans for individuals, families, and seniors.

John Alden Health Insurance

John Alden Life Insurance has been selling health coverage throughout America since 1961. Today, it is part of Assurant. John Alden plans include individual health and small group coverage. It also sells Health Savings Account plans.

Kaiser Permanente Health Insurance

Kaiser Permanente is the nation’s largest non-profit health insurance provider with 8.2 million members across nine states in the U.S.

Time Insurance Health Insurance

Today, Time Insurance is known as Assurant Health with insurance coverage for individuals, students, families, seniors, and businesses.

Time Short Term Health Insurance

Today, Time Short Term health insurance is offered through the Assurant name. Time short-term health plans provide comprehensive coverage for a temporary period of time at affordable rates.

WorldIns ExpressMed Health Insurance

World Insurance offers several types of individual health insurance ranging from dental coverage to comprehensive major medical plans.

Important Contacts and Links

California Department of Insurance and Public Health

Find the contact information for the California health insurance and health care services departments at:

California Department of Insurance
Consumer Services Division
300 South Spring Street, South Tower
Los Angeles, CA 90013
Phone: (916) 322-3555
http://www.insurance.ca.gov/

California Department of Health Care Services
P.O. Box 997413
Los Angeles, CA 90013
Phone: (916) 445-4171
http://www.dhcs.ca.gov