How Can I Help? – Frequently Asked Questions:
Health Care
This page provides answers to Frequently Asked Questions on Health Care issues to help you resolve concerns with federal agencies on your own.
However if you still need help after reviewing this information, contact my Camarillo or Solvang office and my staff will open a case and we will act as your liaison with the appropriate federal agency.
• Where can I buy health care insurance in California?
• I have a pre-existing condition and haven’t been able to find health insurance. Is help available?
• What is COBRA?
• Is there help available for people who cannot afford their prescription drugs?
• What is Medi-Cal?
• How can I find more information about Medi-Cal?
• My insurance company has denied my claim. Can I appeal?
• Where can I get more information about the Temporary Federal High Risk Pool?
Question: Where can I buy health care insurance in California?
Answer: Whether you are an individual or an employer, the California Department of Insurance has information about how to find health insurance plans.
Question: I have a pre-existing condition and haven’t been able to find health insurance. Is help available?
Answer: The Major Risk Medical Insurance Program (MRMIP) provides health insurance for Californians who can’t find health insurance because of pre-existing conditions. Although the state subsidizes coverage through tobacco tax funds, participants must pay part of their premiums. To be eligible for the program, a participant:
• Must be a California resident;
• Cannot be eligible for both Part A and Part B of Medicare, unless eligible solely because of end-stage renal disease;
• Cannot be eligible to purchase any health insurance for continuation of benefits under Cobra or CalCobra;
• Must be unable to secure adequate coverage.
For more information, including how to apply for MRMIP, please to the MRMIP homepage or call 1-800-289-6574.
Question: What is COBRA?
Answer: The Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefit provisions of 1986 allows some former employees, retirees, spouses, former spouses, and dependent children who were covered under a group health care plan the right to temporary continuation at group rates. This coverage, however, is only available under certain circumstances. For more information about COBRA, including eligibility, please see FAQs For Employees About COBRA Continuation Health Coverage.
Question: Is there help available for people who cannot afford their prescription drugs?
Answer: The Partnership for Prescription Assistance provides help for people who are unable to pay their prescription drug costs. For more information about this program, please see the Partnership for Prescription Assistance web site or call 1-888-477-2669.
Question: What is Medi-Cal?
Answer: Medi-Cal is California’s Medicaid, or public health insurance program, which provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, pregnant women, and low-income people with specific diseases such as tuberculosis, breast cancer or HIV/AIDS. Medi-Cal is financed by the California and federal taxpayers.
Question: How can I find more information about Medi-Cal?
Answer: For information about Medi-Cal, including who is eligible for assistance, a list of Medi-Cal providers, and how to report Medi-Cal fraud and abuse, please see the California Department of Health Care Services’ Medi-Cal page.
Question: My insurance company has denied my claim. Can I appeal?
Answer: If you have a complaint or question about how an insurance company has handled your claim, please contact:
Consumer Services Division
300 South Spring Street, South Tower
Los Angeles, CA 90013
1-800-927-HELP (4357)
8 a.m. to 6 p.m.
Monday through Friday (except State holidays)
Question: Where can I get more information about the Temporary Federal High Risk Pool?
Answer: The new health care reform law creates a high risk pool for some people who have been unable to get insurance because they have a pre-exisitng condition. In order to be eligible for the high risk insurance, a person must:
- Be a U.S. citizen or legally present in the United States.
- Have not had health insurance for the previous 6 months before applying for coverage.
- Have a pre-existing condition, as determined by the U.S. Health and Human Services Secretary.
For more information about the program, please visit the California Managed Risk Medical Insurance Board.
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