California



 

About Health Insurance in California

California residents have access to a vast number of excellent health care companies, and we are here to find the most effective one for your needs. East Coast Health Insurance connects you with the best California health insurance available, through reputable names like Aetna, Cigna, Blue Cross, Blue Shield, Health Net, and Kaiser Permanente.

Statistics

  • Total Population: 36,899,700
  • Total Uninsured Population: 7,162,700 (16%)
  • Average Cost of Inpatient Hospital Visit Per Day: $2,566
  • Average State Premium for Individual Health Insurance: $157

Information provided by Kaiser Family Foundation, 2010.

Choosing a Plan in California

East Coast Health Insurance makes it easy for you to get a California health insurance quote, start by entering your zip code above, or for extra assistance you can speak with one of our experts finding the best rates for you over the phone at 888-803-5917.

California Health Insurance Market Overview and Laws

California has many health insurance laws to protect the individual who has a health insurance plan and also work in favor of the insurance company.

Much like other states, the guaranteed renewability provision is in place. Because of this law, your insurer must allow you to renew your existing policy if you have met your premiums and have not violated your policy.

In California, a pre-existing condition exclusion period can be placed on any health insurance plan. The exclusion periods can vary in length, but are limited based on the number of individuals are on your plan. If you received continuous coverage for your illness on  another plan, you are allowed to use the old plan as a credit toward the exclusion period expenses.

Also, if a health insurance plan covers dependents, it is required by law that newborns and adopted children be covered under their parents’ individual health insurance for the first 31 days after birth or adoption.

Dependents with disabilities are able to receive coverage after the age limit has been reached in California, so they can stay on their parents’ plan.

Insurance companies

California health insurance companies are allowed various liberties, and are not held liable for denying someone coverage, or certain other restrictions or charges they may place on a plan. You may be refused health insurance based on your health status, or you may be accepted and charged a higher premium.

Here is a law that does work in your favor: If you are accepted for a health insurance plan, they are not allowed to terminate your benefits if you become ill.

Temporary coverage is also available for times when there is a break in a group health insurance policy. Insurers can issue a conversion plan, where you receive the same benefits as the group coverage, but for a limited time. This is a great solution, though not a permanent one, so it is helpful to find a more long term plan in the interim of a conversion plan.

Coverage

It is required by law that California health insurance companies cover the following medical expenses:

  •     Breast, cervical, and prostate cancer exams
  •     Immunizations
  •     Same coverage for physical and mental health care
  •     Care for women during and after pregnancy
  •     Cancer clinical trials care

For more information, reference the California Department of Insurance site.

Public Health Insurance Plans in California

The Department of Health Care Services’ (DHCS) mission is to preserve and improve the health status of all Californians.  DHCS works closely with health care professionals, county governments and health plans to provide a health care safety net for California’s low-income and persons with disabilities.

Medi-Cal is California’s Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes. You can apply for Medi-Cal benefits regardless of sex, race, religion, color, national origin, sexual orientation, marital status, age, disability, or veteran status. If you are found (or determined) eligible, you can get Medi-Cal as long as you continue to meet the eligibility requirements

Your local County Welfare/Social Services Department manages Medi-Cal eligibility determinations. If you have questions, you can find the addresses and telephone numbers under County Social Services Office Listing.

About the Healthy Families Program

The Healthy Families Program is low cost insurance that provides health, dental and vision coverage to children who do not have insurance today and do not qualify for no-cost Medi-Cal.  When you enroll your child in Healthy Families, you choose the health, dental, and vision insurance plans. The plans provide the health, dental, and vision coverage for your child. This insurance pays most of your child’s costs for visits to doctors, dentists, eye doctors, and specialists. The insurance plans also contract with clinics, laboratories, pharmacies, and hospitals for your child’s health care.

California High Risk Medical Insurance Program

California uses the federal PCIP program to offer health care insurance coverage to residents through the federally established temporary high-risk pool program.

California Health Insurance Market Overview

Strengths:

  • Low prevalence of smoking
  • Prenatal health care is among the best in the nation
  • Low infant mortality rate

Challenges:

  • High rate of uninsured population
  • Air pollution has severe effects on health of California residents
  • Low immunization coverage

Highlights:

  • Although 852,000 fewer adults smoke in California compared to 10 years ago, nearly 3.4 million adults still smoke.
  • Over 6.9 million adults in California are obese, 2.0 million more adults than 10 years ago.
  • In the past ten years, diabetes increased from 6.8 percent to 8.6 percent of adults. Now 2.4 million California adults have diabetes.
  • In the past five years, the percentage of children in poverty increased from 18.5 percent to 23.0 percent of the population.
  • California ranks lower for determinants than for outcomes, indicating that overall healthiness may decline over time.

 

Sources:

1.Kaiser Family Foundation, “California – State Health Facts”. www.statehealthfacts.org

2. Health Insurance In-Depth, “California Health Insurance”. http://www.healthinsuranceindepth.com/health-insurance-California.html

3.  CA.gov Department of Health Care Services, “Medi-Cal”, http://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx