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Living with Diabetes
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California
The following information details health insurance and assistance programs available to uninsured people in California.
California Department of Insurance - (800) 927-4357 visit the Website or call for questions on Indemnity and PPO health plans.
In California, state law allows health insurance companies to turn people down for individual health insurance coverage based on the status of their health. In most cases, diabetes is considered an “uninsurable” condition. Even though you can be turned down for an individual policy in California, you can never be turned down for health insurance that is offered through an employer.
If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Insurance Department. They may be able to provide you with assistance in reaching a conclusion.
California Department of Managed Care - (888) 466-2219 visit the Web site call for questions on HMO health plans.
In California, state law allows health insurance companies to turn people down for individual health insurance coverage based on the status of their health. In most cases, diabetes is considered an “uninsurable” condition. Even though you can be turned down in California, you can never be turned down for health insurance that is offered through an employer.
If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Department of Managed Care. They may be able to provide you with assistance in reaching a conclusion.
California MediCal - Department of Health Services - (916) 552-9200
This program is available to anyone who meets income and eligibility criteria. Even if your income meets the criteria, you must fall into one of the eligibility categories in order to qualify. Contact your state Medicaid program for more information.
California Major Medical Insurance Program (PDF) - (800) 289-6574
The California Major Medical Insurance Program (MrMIP) is the California state high-risk pool. This program allows individual health insurance policies to be sold to people who might otherwise be considered “uninsurable” for this type of policy because of a chronic illness. Premiums may be high, and a pre-existing condition period may apply. Contact MrMIP for more information.
Healthy Families- State Children’s Health Insurance Program - (800) 880- 5305
Healthy Families is the children’s health insurance program designed to provide coverage to children and teens up to age 19 whose families may have too great an income to qualify for MediCal, but who may not be able to afford health insurance. Visit the Web site to find out if you or your child meets the income guidelines.
Pre-Existing Condition Insurance Plan (PCIP)
Through the Affordable Care Act, uninsured people with diabetes who have been continually uninsured for six months or more will be able to access insurance through a new program called the Pre-Existing Condition Insurance Plan (PCIP). PCIP, which is administered by either your state or the U.S. Department of Health and Human Services, will be available until the provisions banning discrimination based on pre-existing conditions are fully implemented in 2014.
PCIP will be available in every state, but the program may vary depending on the state. Currently, many states run programs, often called “high risk pools,” to offer insurance for those with pre-existing conditions. To build on what states are already doing, states can either run a new program with resources from the Affordable Care Act or rely on the U.S. Department of Health and Human Services to provide coverage. Please check out the State Plans page to learn more about how PCIP works in your state. http://www.pcip.gov/StatePlans.html
Local Community Health Clinics
If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free to patients or require a very small fee. Find a clinic in your area.
