High Risk Health Insurance in California

High risk people in California have several options for heath insurance. They can either apply for the state run health insurance plan or opt for the federally run high risk pool that started during the summer of 2010.

Two Options

• With California's federal high risk pool, any U.S. citizen or legal immigrant can apply for coverage if they have a preexisting condition and have lacked health insurance for six months. Only California residents can apply for the state-run Major Risk Medical Insurance Program. The state program also requires proof that the applicant could not buy private health insurance during the past year.

Coverage

• The federal plan covers preexisting conditions without restrictions. One of California's plans requires people to wait for three months before receiving services for a preexisting condition. Another type of the state plan provides no benefits at all for three months after an applicant's enrollment.

Cost

• As of August 2010, the federal plan caps a person's cost share at 35 percent of benefits paid and sets out-of-pocket maximums at $5,950 for an individual and $11,900 for a family. The state plan sets a higher cost share limit at 60 percent, but a lower out-of-pocket maximum. An individual will not pay more than $2,500 annually, and a household no more than $4,000 annually.