Affordable Health Insurance
Affordable Health Insurance
According to America’s Health Rankings, California ranks 44th in the nation in terms of percentage of population lacking health insurance, with 18.4% of its population lacking health insurance.
California’s health insurance companies determine rates for individual insurance policies based on geographical location, age, medical history and other rating factors. Individual insurance policies are subject to medical underwriting and can be denied due to pre-existing medical conditions for twelve months.
When do you need to buy individual California Health Insurance?
One needs to pursue individual health insurance if all of the following are true:
a) If your employer does not offer health insurance benefits
b) If you cannot be named as a dependent on another person’s insurance policy
c) If you are not a member of a professional or a trade organization that offers health insurance
Types of Health Insurance in California
a) Indemnity Policies (Traditional Fee for Service Health Insurance)
Indemnity Policies offer tremendous freedom with respect to choice; one is free to visit any provider in California for covered medical services.
b) Preferred Provider Organization (PPO)
A Preferred Provider Organization provides a list of contracted providers; one receives the best services at the lowest cost if one restricts oneself to the limited list of providers in California for their health insurance needs.
c) Health Maintenance Organization (HMOs or Managed Care)
HMOs require members to obtain their medical services from doctors and hospitals affiliated with the particular HMO in California for their health insurance needs.
d) Self-Insured Health Plans
Large employers in California often have self-insured health insurance plans where all contributing employees pool in their contributions to pay for the medical services for the members of the plan.
State of California’s Health Insurance programs for Individuals in High Risk Pools
State of California provides special programs like Managed Risk Medical Insurance Board to provide affordable health insurance for low income individuals, pregnant women, children and individuals who cannot buy health insurance in the open market.
California Health Insurance Regulations
CAL-COBRA
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is federal law that extends one’s current group health insurance under certain qualifying events such as termination of employment or reduction of hours to part-time status. To be eligible for COBRA, the employer needs to have more than 50 employees.
CAL-COBRA provides COBRA provisions for employers between 2 and 50 employees and provides employees with ability to extend one’s group coverage under certain qualifying events such as termination of employment.
HIV
According to California Department of Insurance, ‘A health insurance company cannot require you to disclose your HIV status or take an HIV test as part of the application process (see California Insurance Code [CIC] Section 799.09). However, it can ask if you have received medical treatment for AIDS, AIDS-related complex (ARC), or an immune system disorder other than HIV/AIDS.
Resources for Health Care Insurance in California
Georgetown University’s guide to Health Insurance in California
Georgetown’s Health Policy Institute has researched and written state guides for buying affordable health insurance in every state.
US News Rankings for best commercially-available health plans. Rankings reflect member satisfaction and success in preventing and treating illness compared with other commercial plans. The highest possible score is 100.
Health Care Advocacy Groups in California
California Health Care Foundation
The California HealthCare Foundation is an independent philanthropy committed to improving the way health care is delivered and financed in California. By promoting innovations in care and broader access to information, its goal is to ensure that all Californians can get the care they need, when they need it, at a price they can afford.
California Center for Public Health Advocacy
The California Center for Public Health Advocacy (CCPHA) is a nonpartisan nonprofit organization that raises awareness about critical public health issues and mobilizes communities to promote the establishment of effective state and local health policies.
Health Coverage Guide for California
Health Coverage Guide was created to provide independent, unbiased information to small business owners in California. It is not affiliated with any insurance companies, nor does it recommend any specific company or policies.