Described as the California Major Risk Medical Insurance Program, the High Risk Pool is a sort of health insurance program that comes as a boon for the California residents reported with pre-existing health conditions.
California Health Plans High Risk Pool is a federally instituted high-risk pool program of temporary nature. California started this health plans program in the year 2010 with the objective of offering health plans coverage for California residents who are denied a health insurance policy on grounds of pre-existing health conditions. This program helps families in California to purchase health plans policies in the event where one or more of the family members are reported with a history of medical problems.
One can understand this program as an insurance option meant for people who can afford to buy a insurance policy, but are not able to purchase a policy in the private insurance market on account of pre-existing health conditions. It is mandatory for the health plans firms in California to contribute to this pool in order to keep it in the black. This program is administered by the Managed Risk Medical Insurance Board. In addition, the California Health plans High Risk Pool program allows people to switch between jobs and employers or choose a self-employment program as a career option. In either cases, the subscribers can free themselves from the fear of losing their health coverage.
There are certain parameters that enable people to qualify for the California Health High Risk Pool program. Those subscribing to this program need to be a citizen of the United States or should be lawfully present n the United States. Before applying to this insurance program, the subscribers should have stayed without any insurance coverage for not less than a period of six months preceding the state in which the application for coverage is filed under the high risk pool. California high risk pool coverage is offered only to those residents who have pre-existing health conditions. They should also produce a history where they were denied of a health plans coverage in California within the past 12 months. Alternatively they should have been offered an individual insurance policy at a premium rate that is higher than the California Major Risk Medical Insurance Program (MRMIP) preferred provider organization (PPO) during the twelve months period preceding the date of applying.
The California pre-existing condition health plan offers coverage for a wide range of health care issues including primary health care, specialized treatments, hospitalization and prescription of drugs. This coverage bestows all the options of a health policy including the treatment of a pre-existing health condition. However, the rates of premium are decided on the basis of the age of the subscribers and the region in California where they reside. As on date, the typical monthly premium in this program for a 50 year old subscriber residing in California is $428. The annual out-of-pocket medical expenditure allowed is $2,500 for health care within the network, while there is no maximum limit specified for treatments out-of the network.