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Public or Subsidized Health Insurance
 Public Programs for Low/Modest-Income People
Other Programs for Low/Modest-Income Children
Programs for "Medically Uninsurable"
Programs for Seniors
State and federal programs such as Medi-Cal and Healthy Families provide coverage for many low-income children, their parents, and aged, blind or disabled individuals. These programs provide comprehensive benefits at low or no cost for those who qualify, but often have extensive, complicated rules about who qualifies.
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In the tool box, see "Public and Subsidized Insurance Programs" for specific programs and information about eligibility guidelines. |
Public Programs for Low/Modest-Income Individuals and Families
Medi-Cal. Medi-Cal is California's version of the federal Medicaid program. It provides comprehensive publicly funded health insurance coverage to low-income Californians who meet specific eligibility criteria. Individuals may qualify for fully subsidized Medi-Cal if they meet income guidelines and fall into one of the following categories:
- Aged, blind, or disabled according to Social Security rules.
- Children and pregnant women.
- Individuals with specific health care needs including dialysis, tuberculosis services, intravenous nutrition services, and short-term nursing home stays.
Individuals who exceed income limits may still be eligible for Medi-Cal, but are required to pay a share of the cost of their health services. Undocumented immigrants do not qualify for Medi-Cal, except for emergency and pregnancy-related services and some nursing home care. Like other Medicaid programs, Medi-Cal is jointly funded by the state and federal governments.
For those receiving Supplemental Security Income/State Supplemental Payments (SSI/SSP) or CalWORKs, Medi-Cal coverage is automatic. Others may apply for Medi-Cal at their local county welfare office or at one of the many hospitals and clinics where county eligibility workers are outstationed. Pregnant women and children may also apply for Medi-Cal by mailing in a form.
Healthy Families. The Healthy Families Program is a state and federally funded health insurance program for children with family incomes above the level eligible for no-cost Medi-Cal and below 250 percent of the federal income guidelines (in 2003, $38,150 for a family of three).
Access for Infants and Mothers (AIM). AIM is part of California's efforts to increase medical coverage of pregnant women and their infants. AIM provides low-cost insurance to women and newborns whose family income is too high to qualify for no-cost Medi-Cal.
Health Insurance Premium Payment (HIPP) Program. Under HIPP, the State of California pays private health coverage premiums for some Medi-Cal beneficiaries. By purchasing health coverage premiums for Medi-Cal beneficiaries, the Medi-Cal program defers the cost for medical care to private health insurance carriers or private health plans. To enroll in this program, employees must meet all of the following criteria:
- Be eligible for Medi-Cal and have a Medi-Cal share-of-cost of $200 or less.
- Have a high-cost medical condition (pregnancy, HIV/AIDS, organ transplant, and so on).
- Currently have private medical coverage or be covered under an employer-sponsored medical plan (including COBRA or CalCOBRA).
- Have filed an application in a timely manner allowing sufficient time to process the application and start payment of premium.
Programs for Low/Modest-Income Children
CaliforniaKids. CaliforniaKids provides preventive and primary medical coverage for children ages 2 to 18 of working families regardless of immigration status. To qualify, children cannot be eligible for Medi-Cal or Healthy Families, nor have access to workplace medical insurance.
Kaiser Permanente Cares for Kids. Kaiser Permanente offers the Child Health Plan-1 for uninsured children from families with incomes between 250 and 300 percent of the federal income guidelines, and who do not qualify for government-sponsored programs. Kaiser's Child Health Plan-2 is a pilot program providing subsidized coverage to children in parts of Los Angeles, regardless of immigration status.
Programs for "Medically Uninsurable"
Major Risk Medical Insurance Program. The Major Risk Medical Insurance Program, better known as MRMIP, provides medical insurance for Californians who have been denied medical coverage in the last 12 months because of a medical condition. This program was developed to provide health insurance for Californians who are unable to obtain coverage on the open market. Participants pay premiums on their own behalf and the MRMIP supplements those premiums to cover the cost of care. Medical insurers contract to provide MRMIP recipients with a comprehensive benefit package.
Programs for Seniors
Medicare. Individuals over 65, regardless of income, qualify for coverage under the federal Medicare program. Medicare also covers some disabled people under 65 years of age.
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