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Group Medical Insurance in California

Group medical insurance is insurance you may get through your job or union, or as a retiree. It usually costs less than individual medical insurance, which you buy on your own.

Sign Up for Group Medical Insurance

  • When you start a new job, ask how to sign up for medical insurance, when your medical insurance starts, and what your share of the cost is.
  • Compare plans. Look at all the plans your employer offers to find the one that offers the most benefits you need.
  • You can add new dependents to your medical plan when you marry, have a baby, or adopt a child. You may also be able to add a domestic partner. When you add someone to your medical plan, your monthly premium may go up.
  • Most employers have Open Enrollment in the fall of each year. Open Enrollment is when you can change your benefit choices. For example, you can change medical plans if your employer offers more than one plan.

Waiting Periods and Pre-Existing Conditions

The California group medical plan at your new job cannot refuse to cover you if you have a pre-existing condition (an injury or illness that started before you joined the plan). However, some plans have a waiting period before the pre-existing condition is covered. The waiting period cannot be more than 6 months.

  • There is no waiting period if you have not had diagnosis or care for your injury or illness in the last 6 months.
  • There is no waiting period if you had previous medical insurance for 6 months with no gaps of more than 62 days before your last insurance ended and the new insurance starts. This is called having creditable coverage.
  • There is a shortened waiting period if you had medical insurance for less than 6 months with no gaps of more than 62 days before your last insurance ended and the new insurance starts.

Keep Your Group Medical Insurance

Federal COBRA and Cal-COBRA are laws that help you keep your group medical insurance for a certain amount of time if your job ends, your hours are cut, or you change jobs and there is a waiting period before your new medical insurance starts. You will have to pay the premiums yourself. But it may cost less than individual medical insurance, which is insurance that you buy on your own. And the benefits may be better.

These laws also help your spouse, former spouse, or child keep medical insurance after your job ends, or after divorce or your death.

Before Your California Medical Insurance Ends

  • Get a letter from your medical plan that says how long you were insured. This is called a Certificate of Creditable Coverage. You may need this letter when you get new group medical insurance or apply for individual medical insurance.
  • Shop for new insurance. Compare the cost of COBRA to the cost of individual medical insurance.
  • If you buy individual medical insurance, wait until you are approved before you end your old insurance. It can take a month or two from the time you apply until you are approved.

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