- 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.
- 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.
- 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.
Two Options
Coverage
Cost
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