State of California Health Resources
Total list of California State Health Programs
List of related programs and services that can help you find assistance, health care services for low-income individuals and families, for the elderly, personal care, specific diseases and children with special medical needs.
- Access for Infants and Mothers
Low-cost health coverage for pregnant women.
- American Indian Infant Health Initiative
Provide extensive home visiting/case management services to high-risk Indian families.
- Assisted Living Waiver Pilot Project (ALWPP)
The ALWPP is the Medi-Cal program that pays for a bundle of specific Assisted Living benefits provided to eligible beneficiaries residing in Sacramento, San Joaquin or LA Counties.
- Breast and Cervical Cancer Treatment
California provides free cancer screening for breast and cervical.
- CalMEND
California Mental Health Care Management Program.
- Cancer Screening and Detection Program
Free cancer screening for some types of cancer.
- California Children’s Services
Treatment for children with chronic/life threatening health conditions/diseases.
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- Child Health and Disability Prevention
Preventive health program for low-income children and youth.
- Children's Medical Services
Provides a comprehensive system of health care for children through preventive screening, diagnostic, treatment, rehabilitation, and follow-up services.
- Community-Living Support Benefit Waiver Pilot Project (AB 2968)
Requires DHCS to provide a new Medi-Cal community-living support benefit to increase access to needed health-related and psychosocial services for persons residing in the City or County of San Francisco.
- Denti-Cal
Dental Services are currently provided as one of the many benefits under the Medi-Cal program. The beneficiary services department within the Medi-Cal Dental Program offers a variety of Services for program beneficiaries.
- Home and Community-Based Services for the Developmentally Disabled
The Home and Community-Based Services for the Developmentally Disabled (HCBS-DD) Waiver authorizes home and community-based services for developmentally disabled persons who are Regional Center consumers.
- Estate Recovery
Recovers Medi-Cal expenditures from the estates of certain deceased Medi-Cal beneficiaries for services received on or after the individual’s 55th birthday.
- Fair Hearing
Complaints about how benefits/services are/were handled, or if services have been denied or modified.
- Family Planning, Access, Care and Treatment
Comprehensive family planning services to eligible low income men and women.
- Genetically Handicapped Persons Program
Treatment for specific genetic diseases.
- Gynecologic Cancer Information Program
The Gynecologic Cancer Information Program (GCIP) was established in statute (California Health and Safety Code 138.4) within the Office of Women's Health to increase awareness and education regarding gynecologic cancers.
- Health Care Program for Children in Foster Care
Provides public health nurse expertise in meeting the medical, dental, mental and developmental needs of children and youth in foster care.
- Health Insurance Premium Payment
Health Insurance Premium Payment Program is a program that pays private health insurance premiums for certain high cost Medi-Cal beneficiaries.
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- Health-e-App (Provider Information only)
- Healthy Families
Low cost insurance for children and teens. It provides health, dental and vision coverage to children who do not have insurance and do not qualify for free Medi-Cal.
- Healthy Kids
Healthy Kids is a low-cost health care program available in many counties for children who are not eligible for full Medi-Cal or Health Families.
- High Risk Infant Follow-Up
Limited diagnostic services for children up to three years of age.
- In Home Operations
In-Home Operations (IHO) is a section oversees the development and implementation of home- and community-based programs under Medi-Cal.
- IHSS Plus Waiver
Personal care and domestic services to persons who are aged, blind or disabled and who live in their own homes.
- Indian Health Program
Improve the health status of American Indians/Alaska Natives (AI/AN) living in urban, rural, and reservation/rancheria communities throughout California.
- Intermediate Care Facility for the Developmentally Disabled-Continuous Nursing (ICF/DD-CN) Pilot Project)
The waiver requires the Department to commit to maintaining access to care, provision of quality services, adhering to cost effectiveness, and open access to emergency services for the target population eligible for services under the waiver.
- Long-Term Care
Increases the number of middle-income Californians who have quality long-term care insurance that prevents or delays their dependence on Medi-Cal.
- Medi-Cal (Indivduals and Families)
This is a public health insurance program which provides needed health care services for low-income individuals and families.
- Medi-Cal Eligibility Division
The Medi-Cal Eligibility Division (MCED) is responsible for the coordination, clarification, and implementation of Medi-Cal regulations, policy, and procedures to assure that Medi-Cal eligibility is determined accurately and on a timely basis by the 58 county public social services agencies.
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- Medical Case Management
Medical Case Management (MCM) provides short-term case management for Medi-Cal recipients which require medically intensive services.
- Medi-Cal Managed Care
Contracts for health care services through established networks of organized systems of care, which emphasize primary and preventive care.
- Medi-Cal Pharmacy Benefits
Medi-Cal Pharmacy Benefits include Fee-For-Service Drug Program, Drug Rebate Program, Enteral and Medical Supplies Contracting, Drug Contracting, and Vision Care.
- Medi-Cal Waivers
Medi-Cal Waivers are programs that demonstrate and evaluate new health care delivery systems. These programs focus on reducing costs and providing services in a community based setting.
- Medical Therapy
Occupational Therapy (OT) and Physical Therapy (PT) for children with eligible conditions.
- Multipurpose Senior Services Program (MSSP) Waiver
The MSSP waiver is targeted to those medically fragile individuals over the age of sixty-five and is administered through MSSP sites throughout the state, under the California Department of Aging.
- Newborn Hearing Screening
Helps identify hearing loss in infants and guide families to the appropriate services needed to develop communication skills.
- Newborn Screening
Testing for specific genetic disorders.
- Office of Clinical Preventive Medicine
Strives to promote collaboration and understanding between public health authorities and health care providers.
- Office of Multicultural Health
Reduce gaps in health status among and improve the quality of life of California's diverse populations.
- Office of Public Affairs
The Office of Public Affairs is responsible for the overall communications and outreach activities.
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- Office of Women's Health
Improving the status of women's health.
- Overpayments
The primary function of the Overpayments Unit is to recover funds due the Medi-Cal program.
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Program of All-Inclusive Care for the Elderly (PACE)
The PACE model of care provides a comprehensive medical/social service delivery system using an interdisciplinary team approach that provides and coordinates all needed preventive, primary, acute and long term care services
- Personal Injury
The Personal Injury Unit is responsible for the recovery of Medi-Cal expenditures in personal injury actions involving Medi-Cal beneficiaries.
- Presumptive Eligibility for Pregnant Women
Allows Qualified Providers to grant immediate, temporary Medi-Cal coverage for ambulatory prenatal care and prescription drugs for conditions related to pregnancy to low-income, pregnant patients, pending their formal Medi-Cal application.
- Primary and Rural Health Care
Improve the health status of special, targeted population groups living in medically underserved urban and rural areas of California.
- Senior Care Action Network (SCAN)
SCAN Health Plan is a Medicare Advantage Special Needs Plan that provides all services in the Medi-Cal State Plan. Participants must be 65 years or older, Medi-Cal and Medicare eligible and reside in the SCAN service area.
- Subacute Care Program
Specific reimbursement rates have been developed for providers of subacute care who have been licensed and certified by the DHCS’ Licensing and Certification program.
- Women, Infants and Children (WIC)
Nutrition program that helps pregnant women, new mothers and young children eat well and stay healthy.
- Workers Compensation Recovery Program
Responsible for identifying and recovering Medi-Cal expenditures made on behalf of beneficiaries whose injuries are covered by Workers Compensation liability.
- Working Disabled Program
Allows certain individuals to become eligible for Medi-Cal by paying low monthly premiums based on countable income.
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Public and Non-Government Programs
Health Insurance Resources
This list is an attempt to provide the public with access to information and resources about health insurance options. Every effort has been made to provide sources that appear to be reputable; however, the information listed has not been independently verified. Furthermore, Scarborough does not endorse or guarantee any of the programs listed. It is strongly recommended that you verify the quality of any plan as well as ensure that the plan meets your specific needs. You also need to be sure to check that the provider is licensed as an insurance company in California before relying on it for health coverage. Check the Quick Tips list from the California Department of Insurance for suggestions on how to do that.
Please let us know if you can suggest additional resources, or if you find that any of these links are out of date.
General Information and Resources
Independent Ratings and Information
Selected Association Plans
Brokers
Short-Term Solutions: Low-Cost Clinics in some Bay Area Locations
General Information and Resources
Health Insurance Resource Center
Extensive website listing a range of options for health insurance plans, including a section for Self-Employed Persons and Small Businesses. A great place to start your research.
California HealthCare Foundation
Includes listing of group coverage options, as well as clear general information about types of health insurance, working with a broker, and more. Some of the information is aimed at small businesses rather than individuals, but it can be a useful starting point for acquiring basic information about how health insurance works. See also: California Health Coverage Guide.
Foundation for Health Coverage Education
Provides information about health insurance programs for which you may be eligible, including programs for low-income families, children of moderate income families, major risk programs and COBRA. Take a look at the downloadable Finding Health Care Coverage in California booklet. Will also provide referrals to private brokers.
Health Rights Hotline ”for El Dorado, Placer, Sacramento and Yolo counties only
Provides free assistance and information about consumer rights in health care. Trained counselors answer general questions about consumers' rights in health care and help consumers resolve specific problems with their health coverage.
Georgetown University Health Policy Institute ”Consumer Guides for Getting and Keeping Health Insurance
California guide is currently unavailable, but may be updated and reposted. Guides for other states are available on the website.
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Independent Ratings and Information
The State of California Office of the Patient Advocate
Offers independent ratings of health plans.
Healthscope
Provides independent performance ratings for health plans and medical groups, and has a search tool for identifying doctors and the health plans with which they are affiliated.
California Department of Managed Care
Maintains resources where you can check if a health plan you are considering is licensed in the State of California and whether or not it has complaints filed against it. See also the California Department of Insurance Quick Tips.
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Selected Association Plans and Other Programs
Some group plans simply provide group rates, which may or may not be less expensive than individual rates. Others allow members to avoid the medical underwriting process. (Medical underwriting is the process of evaluating your personal medical history used by insurance carriers to assess their risk in providing insurance to you. If a policy is medically underwritten, it means that your rates can vary according to the carrier's risk assessment, or you could be denied coverage if the carrier considers you to be high-risk.)
Some of our members have commented that if you do have a clear medical history, it may be advantageous to get an individual plan which will allow you to keep it for the long-term. Association plans are coming under increasing scrutiny and may not be around forever. Of course, getting accepted for an individual plan, and getting your rates set at a reasonable level, can be a challenge even for those with minor pre-existing conditions, so it may be a good idea to consider applying for an individual plan if you do not yet have a history of medical issues.
The Entertainment Industry Group Insurance Trust
Affiliated with several professional associations, i.e. American Institute of Graphic Artists or National Association of Science Writers. You must join one of these organizations to be eligible for coverage through TEIGIT. Does not require medical underwriting. Other associations you may qualify to join are listed on the Health Insurance Resource Center website.
Japanese-American Citizens League
Membership is open to the general public, but the health insurance plans do require medical underwriting.
California Alumni Association
Membership is open to non-alumni community members as well, and benefits include access to a health insurance plan at group rates. Coverage generally requires medical underwriting.
Elk Grove Chamber of Commerce ”for Sacramento area
Offers guaranteed issue coverage in Sacramento area only. For more information, contact us.
San Francisco Health Plan
A city-sponsored health plan with several low-cost programs, particularly for children and young adults (under 25) who meet certain income guidelines. Please refer as well to the California Healthy Families website.
Somerton Student Insurance ”Community Colleges of California
Student health plans provided to students enrolled at various colleges in the Bay Area, including City College and other community colleges where it is relatively inexpensive to enroll. Minimum credit hours are required. Review the policy carefully, as some coverage is unusual, such as no coverage for preventive care and cost maximums for diagnostic tests.
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Brokers
According to the California Health Care Foundation, "Brokers charge a basic commission for their services, and sometimes charge extra fees as well. Commissions are typically based on a percentage of the annual premium and are included in the premium that you pay. In other words, the basic commission is built into the insurers' rates, so everyone pays them whether they use a broker or not. Fees, on the other hand, may be charged for certain extra services. You'll need to make sure you know what, if any, fees will be charged when working with a broker. Extra fees are generally paid directly to the broker."
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Short-Term Solutions: Low-Cost Bay Area Clinics
In addition to short-term insurance, which brokers can help you with, there are a number of low-cost or sliding scale clinics in the Bay Area.
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