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California

California Health Insurance

California has more insurance regulations than most states. It's hard to know the details of every law, so we've outlined the most important ones here for your convenience. Familiarize yourself with them so you're more confident and wise and, perhaps most importantly, knowledgeable in your final health insurance purchase.

This guide:

  • Describes California health insurance policy regulations.

  • Lists rules California health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. California health insurance companies and policyholders alike must abide by the established insurance laws.


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Do You Qualify For A Subsidy?


Find out if you qualify for a government subsidy under Obamacare. Millions of Americans will have their insurance rates reduced under the new health care law. Learn how much you could save with our simple calculator.

California health insurance policy provision

Some of the most important California health insurance laws are the ones regulating the health insurance policy specifically.

Insurance laws requires certain provisions to be included in all California health insurance policies. Once such provision is know as the "guaranteed renewable" provision.

This provision states that as long as you have not provided any false information on your application and have paid your premiums on time, your California health insurance policy cannot be canceled by the insurance company...only you have that power. This means even if you fall ill, California health insurance companies must honor the contract by renewing it at your request.

Also, California insurance laws limit the "pre-existing condition" provision some insurance companies may add to your health insurance policy. California health insurance companies can impose an exclusion period for any "pre-existing condition."

During the exclusion period, the health insurance company does not have to pay for any treatment of the specificly mentioned pre-existing medical condition. The length of the exclusion period is limited, depending upon how many people are covered under the policy. Conditions are considered to be "pre-existing" if you have received medical treatment or were diagnosed for them before the beginning of the plan.

If you are switching insurance and have had continuous coverage, it is possible your old coverage can be used to credit the pre-existing condition period of your new plan, meaning that the condition, though it existed before the new policy came into effect, must still be treated under the new policy.

This means if, under your old policy, your condition was excluded from coverage for 2 years and, under your new plan, the exclusion period for your condition is three years, then your new health insurance policy can only be exclude the condition from coverage for one year.

It is important to note here that California regulates the health insurance coverage of your dependents or future dependents.

California health insurance laws state that newborns and adopted children are automatically included under a parentsí individual insurance policy for 31 days as long as the policy already provides coverage for dependents. Handicapped dependents can still be covered under a parent's individual health plan, even if they are over the age limit for coverage.

There are, of course, more provisions that can be added to your California health insurance policy, but the other provisions typically aren't regulated by California health insurance laws.

Regulating California health insurance companies

Understanding the laws limiting California health insurance companies is especially important in making sure your health insurance company continues to honor your original contract. California health insurance companies and the cost of health insurance is not too strictly limited.

For instance, your application for health insurance can be denied on the basis of your health. Also, premiums for your California health insurance policy can be more based on your health.

However, California health insurance companies cannot terminate your existing health insurance policy on the grounds of illness.

Since California health insurance companies can freely deny you coverage, but can't deny your request to renew your existing policy, it makes sense to purchase California health insurance while you are young and healthy. Although your price may increase if you fall ill, you will not be in the unfortunate predicament of being without health insurance.

Temporary California health insurance

Temporary health insurance is crucial in covering, not only your healt expenses, but also your future insurability should you experiance a break in your major health care coverage. We wouldn't be going through this if we didn't both already know that going without health insurance is extremely unwise.

California health insurance companies offer what they call "conversion plans," which are temporary health insurance policies. You are entitled to receive coverage under these plans if you are leaving a fully insured group policy, as what might happen when you change jobs.

Although the cost of premiums may be higher and the benefits you receive under these plans may not be the same as your former insurance policy, no new pre-existing exclusion period is required under these policies.

If you are not eligible for a conversion plan, but need some temporary coverage, some California health insurance companies offer short-term health insurance policies.

More CA health insurance help

If you want more help getting the right health insurance policy, read our guide to health insurance.

Also see the guide to California small business health insurance.


To find out more about CA health insurance laws and regulations, visit the official website of the California Department of Insurance.





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This internet site provides information of a general nature for educational purposes only and is not intended to be legal advice. We make no guarantees as to the validity of the information presented. Your particular facts and circumstances, and changes in the law, must be considered when applying insurance law. You should always consult with a competent insurance professional licensed in your state with respect to your particular situation.