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Government Sponsored Medical Expense Programs

Managed Risk Medical Insurance Board (MRMIB) — The California sponsored health care plans for uninsurable individuals. The benefits are limited and there are residency and waiting periods that must be met before benefits are available. Ask your agent for more information or call 1-800-289-6574 for enrollment forms.

Health Insurance Plan of California (HIPC) —The State of California sponsored a health insurance pool for small employers (3-50 full-time employees). It guarantees coverage to employees in any one of 20 different health plans offered through insurance companies or HMO's at more favorable rates. Your employers can get more information from an insurance agent or by calling HIPC at 1-800-447-2937.

Medicare — a Federal program which provides medical insurance for people over 65 and for those who are permanently disabled. Contact your local Social Security Office for a copy of the current Medicare handbook.

Medicaid — (Called MediCal in California) is funded jointly by state and federal governments but administered by each state. Medicaid provides medical assistance to low-income families and individual of all ages participating in cash-assistance programs. Medicaid recipients usually do not need private health insurance. Contact your local county Social Services Department for eligibility requirements.

The Health Insurance Portability and Accountability Act [HIPAA]

An individual who may have difficulty obtaining individual coverage because of pre-existing medical conditions should contact a qualified health insurance agent and ask for information on "HIPAA-ELIGIBLE, guaranteed-issue" individual health plan. An individual may be eligible to purchase an individual health policy without evidence of good health if she/he meets the following requirements:

1. The individual, or covered dependent, has been covered under an employer-sponsored health benefit plan, including COBRA or Cal COBRA continuation coverage, for at least 18 months;

2. The individual terminated employment and must have elected continuation coverage under COBRA/Cal-COBRA;

3. All available COBRA/Cal-COBRA continuation coverage has been exhausted; (If an
employer terminates its existing group health plan entirely, no more continuation coverage is "available" through that employer or through a successor employer’s plan, continuation coverage has been exhausted.);

4. The individual submits an application, and a "certificate of Prior Coverage" or an acceptable equivalent, for individual coverage to an insurance carrier or an HMO within 63 days of the termination of the group health benefit plan.

The individual does not purchase any kind of other individual coverage, including a conversion policy, a short-term interim plan, the Managed Risk Medical Insurance Plan for uninsurable parties or a medically underwritten individual policy/HMO.

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