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California Health Insurance

Are you looking for California health insurance quotes? You're in the right place. Compare quotes instantly from the leading carriers in the state of California and find out how you can save on top-rated coverage. Enter your California zip code above to find the right plan or browse below for more information about California health insurance plans in your area.
24th Place in State Health Report Card

State Health Report Card

Nearly 3.4 million adults in California smoke, about 850,000 less compared to the last decade. There are more than 6.9 million obese adults in California, two million more compared to ten years ago. In ten years, diabetes cases increased from 6.8% to 8.6% among California adults. Today, there are 2.4 million adult Californians living with diabetes. In five years, children living in poverty increased from 18.5% to 23%.

California Health Insurance Laws and Regulations

Insurance providers in California are not allowed to cancel an existing policy because of any illness. But they may deny coverage to an applicant who is already ill or who may be at special risk. Insurers may raise a policyholder's premium because of illness or injury. California Health insurance companies are required to offer their customers guaranteed renewability. A subscriber's insurance policy will not be cancelled as long as there is no breach in contract. Insurance providers in California can deny coverage for a pre-existing condition, but with limitations. After a certain period, they are required to cover the condition. This period varies depending on the provider. You can also change coverage without going through another period of full exclusion. Newborns and newly-adopted children in California are automatically covered for up to 31 days under state as long as their parent's individual policy covers dependents. Small businesses looking into California health insurance quotes can purchase any form of small-business group health insurance available to other companies. However, a minimum number of enrollees may be required depending on the organization's size and membership. Health insurers cannot charge different premium rates between small businesses based on the employees' health condition. However, rates can vary depending on age or location. Self-employed individuals searching for a California health insurance quote can choose to purchase an individual or a small-business health insurance plan, provided the company has at least one employee.

State Government Insurance Programs Offered

Pre-Existing Condition Insurance Plan (PCIP)

877-428-5060

This is a temporary high-risk pool created by the Health Care Reform and operated by the Managed Risk Medical Insurance Board. This program provides coverage for individuals with a pre-existing condition who have a hard time finding private coverage. Benefits of the plan include office visits, emergencies, preventive care, ambulance, inpatient and oupatient care, x-ray and laboratory services, rehabilitation, surgery and anesthesia, organ transplants, blood and blood products, cancer clinical trials, family planning, pregnancy and maternity care, therapies, inpatient and outpatient services for mental health and substance abuse treatment, and many more. Eligibility: 1. Must be a U.S. resident living in California. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.

Medi-Cal California’s Medicaid Program

800-541-5555 800-786-4346

This the Medicaid program in California and provides coverage for low-income families. Another program known as "Restricted Medi-Cal" is also available to assist the uninsured, immigrants waiting for their legal status, and those seeking emergency-only coverage. This program offers health, prescription, dental, and vision coverage. Pregnancy care (prenatal and delivery) are also available and mothers are covered for up to 60 days after delivery. Services are also available for special problems like breast cancer, kidney problems, nursing home needs, and HIV/AIDS. Eligibility: 1. Must be a U.S. citizen or have a legal immigration status (some groups may be granted exceptions). 2. Must be a resident of California. 3. Must meet income limits. 4. Those under Welfare, Cash Assistance, CalWorks or children leaving Foster Care at age 18 may automatically qualify.

AIM - Access for Infants & Mothers

800-433-2611

This is a program created for low-income pregnant women and infants. Benefits include medical care for mothers during pregnancy and up to 60 days after delivery. Infants can receive care up to 12 months after birth. Eligibility: 1. Must be U.S. Citizen or with legal immigration status and a resident of California. 2. Must be pregnant for not more than 31 weeks. 3. Must meet income limit of 200 to 300 percent FPL. 4. Must not have Medi-Cal or Medicare Part A and Part B benefits as of the application date. 5. Must be uninsured, if applicant has insurance it should have a maternity deductible or co-payment of not less than $500.

Healthy Kids


This program offers health coverage to children in households with low or moderate income who are not qualified for Healthy Families or Medi-Cal. Eligibility for the program varies by county. The program covers health, dental, and vision plans, and also includes hospitalization. Eligibility: 1. Must be a resident in a California county where Healthy Kids is offered. 2. Must be 18 years old and below. 3. Must not exceed the income limit of 300% FPL. 4. More programs are available for enrollees without an employer-sponsored plan for at least 3 months. 5. Must not be eligible for Medi-Cal or Healthy Families.

CaliforniaKids

818-755-9700

This program offers California health insurance to children in moderate income families who cannot afford private insurance, but are not eligible for Medi-Cal, Healthy Families, or other state sponsored programs. Benefits for this program include preventive, medical (outpatient only), emergency room, dental, prescription drugs, and behavioral health programs. Eligibility: 1. Must be children between ages 0 and 18. 2. Must be attending school. 3. Must not be eligible for other state-sponsored plans.

Health Coverage Tax Credit

866-628-4282

Guaranteed Coverage Inpatient and outpatient care (lab tests, x-rays, etc.), Doctor visits, Preventive and major medical care (surgery, physical therapy, Durable medical equipment, etc.), Mental health and substance abuse care, and Prescription drugs. Must be receiving TAA (Trade Adjustment Assistance), or Must be 55 years or older and receiving pension from the Pension Benefit Guaranty Corporation (PBGC). Must not be enrolled in certain state plans, or in prison, or receiving 65% COBRA premium reduction, or be claimed as a dependent in tax returns. Must be enrolled in qualified health plans where you pay more than 50% of the premiums.

Children Health and Disability Prevention (CHDP)


This is a preventive program available to low-income children and youth in California and offers regular health assessments and services. The program helps families with their medical appointment scheduling, transportation, and provide access to diagnostic and treatment services. Benefits include immunizations, dental, hearing, vision, and nutrition screening, and tests for illnesses. Health and tobacco education are also offered. Women-Infant-Children referral is children 5 years and below. This program does not cover emergencies, hospital stays, and prescriptions. Eligibility: 1. Must be Medi-Cal recipients under 21. 2. Children 19 years and below must not exceed 200% FPL income and must not be Medi-Cal recipients. 3. Children under Foster Care, Headstart, and State Preschool programs are eligible for coverage.

Healthy Families

800-880-5305 888-747-1222

This is the state and federally-funded CHIP program in California which offers coverage to children with family income exceeding the limits to qualify them for Medi-Cal. This plan offers emergency, physician, and preventive care; prescription drugs; family planning and maternity care; physical, occupational, and speech therapy; medical, mental, and substance abuse services; home health and nursing care; and medical transportation. Eligibility: 1. Must be U.S. citizens or legal immigrants and California residents. 2. Must be ineligible for Medi-Cal or employer-based insurance coverage.

County Medical Services Program (CMSP)


This program offers basic health coverage to adults with low-income living in California's rural counties. Program availability and benefits may vary depending on the county. Plan holders may access physician and other hospital-related services when medically-necessary. Other services like dental and vision may also be available. Eligibility: 1. Must be U.S. citizen or legal resident and reside in a participating California county. 2. Must be between 21 and 64 years and have income not exceedign 200% of the FPL. 3. Must meet property requirements.

Medicare

800-633-4227

Medicare provides coverage to eligible seniors or those with qualified disability through Medicare Advantage, Medicare Supplement, and Original Medicare. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverge. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.

Heath Care Reform

Under the health care law, children under the age of 26 can choose to stay under their parent's health plan as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In California, nearly 356,000 young adults have insurance coverage through this provision as of June 2011.

The new health care law allowed nearly 355,000 Medicare policyholders in California to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, more than 319,000 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plans when they hit the donut hole. An average of $538 per person or a total of $171,983,735 was saved in California.

Previously uninsured individuals without health coverage because of a pre-existing condition can now apply for a Pre-Existing Condition Insurance Plan, which removes the burden of searching through California health insurance plans. This plan is available to U.S. citizens or legal residents with a pre-existing condition and have been uninsured for at least 6 months. In 2011, more than 5,500 individuals in California have benefited from this new law.

The new health care law requires all health insurers to allocate at least 80 percent of the premium payment on health care and related improvements. A rebate or premium discount shall be provided if the minimum is not met. All private policyholders in California will get greater value for their premium payments because of this 80/20 rule.

With the new law, insurance companies are now required to provide their subscribers with preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits with no dedictible or co-pay. In 2011, more than 2.9 million Medicare subscribers and more than 6 million individuals with private policies received such services in California.

Under the new law, insurance companies are no longer allowed to impose an annual dollar limit-a cap on the yearly spending for your benefits, or a lifetime dollar limit-a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, more than 12 million California residents have benefited from this law.

If insurance companies want to raise their premium rates by ten percent or more, they are required by federal law to publicly announce and justify their actions. To guard against such unreasonable increases, the state of California received a total of $5.3 million.

All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In California, 1,135 community health centers received a total of $248.1 million to fund these improvements.

In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. California has already received a total of $90.6 million to support its policies, programs, and communities to help its residents lead healthier lives.