Health Insurance for Californians

According to healthinsurance.org, a 2010 study by the United Health Foundation discovered that nearly 20 percent of California's population is uninsured, with only five other states reporting a higher percentage of uninsured residents. California's government, as well as 2010 health reform laws, are working to lower the number of uninsured Californians and make it easier for them to acquire coverage.

Public Health Plans

• California, like the other 49 states in the U.S., provide state and federally-funded public health plans to the medically needy and low-income families and individuals. The California Medical Assistance Program, or Medi-Cal program, is California's Medicaid program, which provides free health care to qualifying enrollees. According to the U.S. Department of Health and Human Services, low-income individuals must have an incomes at or below 100 percent of the federal poverty limit to qualify, with the exception of children ages 1 to 5, who can have incomes of 133 percent of the federal poverty level. Pregnant women and newborns also enjoy more liberal Medi-Cal eligibility guidelines, qualifying with incomes of up to 200 percent of the federal poverty limit. Children in households that exceed Medi-Cal limits may qualify for Healthy Families -- California's Children's Health Insurance Program. Though income guidelines change each spring, as of 2011, a child in a family of four could qualify for insurance under the program with a household income of up to $4,657.

Employer and Private Insurance

• California residents may choose to purchase private health insurance either individually or through an employer's group health insurance plan. The federal Health Insurance Portability and Accountability Act oversees employer plans, prohibiting coverage denials to qualifying employees and limiting the amount of time insurers can exclude pre-existing conditions from coverage to between 12 and 18 months. Furthermore, the Affordable Care Act is reforming private health insurance plans between 2010 and 2014, requiring that all states establish state-sponsored health insurance exchanges for residents purchasing individual health insurance. California was the first state to begin setting up an exchange at the end of November 2010, and will offer five levels of health insurance beginning in January 2014.

State PCIP

• Effective October 25, 2010, the state of California began offering its residents access to a state-sponsored pre-existing condition insurance pool. The pool extends health insurance to individuals who cannot find coverage because of an existing medical condition. To qualify, you must legally reside in California and have been uninsured for the six months prior to applying for acceptance into the PCIP. Additionally, you must provide proof that you were denied insurance coverage because of a medical condition in the 12 months prior to applying for coverage.

Complaints

• The California Department of Insurance regulates the state's health insurance plans, ensuring that consumers receive fair treatment by insurance companies. The Department of Insurance is also responsible for handling your complaints against insurance companies, agents, brokers and other representatives should you receive unfair or illegal treatment. You can file a formal complaint through the Consumer Services Division of the California Department of Insurance by calling direct, or you may submit a Request for Assistance through the Consumer Services Division's website. While the Department of Insurance can investigate most complaints, it cannot handle complaints regarding workmans compensation or complaints of pre-paid health plans.