Get Insurance in California

In California, your ability to buy individual health insurance may depend on your health status. California's Managed Risk Medical Insurance Board was designed for individuals who are unable to secure coverage on the private insurance market. Every Californian must go through an application process involving "medical underwriting" in which health history is taken into consideration before a policy is issued. Pre-existing condition waiting periods may be imposed on you for up to 12 months if you let your insurance lapse for more than 63 days.  You should always make sure you have continuous health coverage in order to avoid such waiting periods.

You have four basic options for obtaining health insurance as an individual in California:

• Private Health Insurance
• Insurance for High-Risk Individuals
• Health Insurance through Associations
• Health Insurance through Income Eligible Programs

Please note that insurance companies cannot cancel health insurance because you become ill. This is called guaranteed renewability. Before choosing a plan, you should know there are certain protections afforded by federal and state laws to California residents seeking health insurance.

There are three main types of comprehensive health plans that are available to purchase as an individual/couple/family:

HMO - You must use providers (doctors, hospitals, labs) participating in your HMO. Your HMO network is local and you must get referrals from your Primary Care Physician before you can see specalists.

POS - You may see doctors outside of your plan's network, but you will be responsible for at least 20% of the cost of your care in addition to your copay, plus a deductible as high as $1, 000. Additionally, the premiums will be much higher for the POS plans.

PPO - You will have the freedom to see doctors outside the network for the additional costs outlined for POS plans. PPOs are different from HMOs and POS plans because they offer you a national network of doctors in hospitals. Additionally, you do not have to get a referral from your primary care physician before you see a specialist.

Industry Advantage Health Plans (IAHP) is available to entertainment industry professionals in California.  IAHP allows you to choose any medically underwritten Blue Cross of California health plan with two added advantages. The two added advantages include an expanded industry friendly provider network and a "portability" feature for union members.

Short term health insurance policies are also available to Californians.  Short term policies cover "medically necessary" procedures only.  They do not cover preventative services or pre-existing conditions.

California's Managed Risk Medical Insurance is a program designed to bring access to individuals who are unable to secure coverage on the private insurance market due to health status.  Services in the program are delivered through contracts with private health insurance plans. LIMITATIONS:  Max Annual benefit of $200,000  Max Lifetime Benefit of $750,000. 

If your medical history prevents you from obtaining any of the plans listed above, you may want to consider the option of joining a guarantee issue association plan.  Entertainment Partners, and TEIGIT and Media-Alliance are three such guarantee issue plans that offer HMO and POS plans in California. Each of these organizations has its own eligibility requirements.

Entertainment Partners is an industry payroll service for various entertainment related projects in California.  EP offers eligible individuals guaranteed acceptance into a Blue Shield HMO and a United Concordia dental DHMO.  You must apply for this coverage within 60 days of your last paycheck from Entertainment Partners.

TEIGIT-The Entertainment Industry Group Insurance Trust has administered health insurance plans for members of participating associations in the arts and entertainment industry. Enrollment is automatic for members who meet the eligibility requirements.

Income Eligibility Guidelines:

MCS directly operates California's Medicaid program (Medi-Cal) and the program's eligibility, scope of benefits,reimbursement, and other related components.

The Healthy Families Program offers low cost insurance for children and teens up to age 19. It provides health, dental and vision coverage to children who meet the program rules and do not qualify for free Medi-Cal.

Kaiser Cares for Kids offers low cost health insurance for children and teens under 19 years of age who do not qualify for Medi-Cal or Healthy Families.

The Children's Health Initiative is a subsidized health insurance plan for children who do not qualify for Medi-Cal or Healthy Families because the household income is too large or immigration status issues.

AIM provides low cost health insurance to low-income pregnant women and their infants.

The County Medical Services Program (CMSP) was established in 1982 to provide medical and dental care to medically indigent adults (MIAs) aged 21-64 who are of marginal income and who are not eligible for the State's Medi-Cal Program.

Family PACT is California's innovative approach to providing comprehensive family planning services to eligible low income men and women. This clinical program increases access to services by expanding the provider network to include medical providers, pharmacies and laboratories.

CaliforniaKids Healthcare Foundation helps to keep our children healthy by providing affordable, preventive and primary health care benefits to children of families who do not qualify for any state health care program.

California Children's Services is a statewide program that treats children with certain physical limitations and chronic health conditions or diseases. CCS can authorize and pay for specific medical services and equipment provided by CCS-approved specialists. The California Department of Health Services manages the CCS program.