California offers a variety of healthcare services, ranging from health insurance and health plans to public programs such as Medicare and Medi-Cal. Each of these services is regulated by different government agencies, and they all have their own set of rules. In this article, we'll discuss the different types of health coverage available in California, their descriptions, and the agencies that regulate them.
Health InsuranceHealth insurance is a type of coverage that provides financial protection against medical expenses.
It is regulated by the Department of Managed Health Care (DMHC). The DMHC also oversees some dental and vision care plans, mental or behavioral health plans, and chiropractic plans. These plans are called specialized plans and only cover certain types of care.
Health Plans (HMOs)Health Maintenance Organizations (HMOs) are a type of managed care health insurance system.
They provide medical, dental, and vision care in one place. The DMHC regulates all California HMOs and some other types of health plans. The HMO report card can help you compare the quality of care for HMOs and medical groups in California.
Public ProgramsPublic programs such as Medicare and Medi-Cal are government-funded healthcare programs that provide coverage to eligible individuals.
The Department of Health Care Services (DHCS) oversees Medi-Cal in California. They provide information on renewing your Medi-Cal, language interpretation services, language assistance classes, and more.
Point-of-Service PlansPoint-of-Service (POS) plans are a type of managed care health insurance system that combines the characteristics of an HMO and a Preferred Provider Organization (PPO). If you see a doctor or other provider who is not in your health plan's network, you and your plan share the cost of the service.
Self-Insured Plans Self-insured plans are employer-funded health care plans that don't have to comply with California laws on essential health benefits, complaints, and coverage. As part of the Affordable Care Act, California created a health insurance marketplace called Covered California. This type of health coverage is different from traditional insurance policies and is governed by a different set of laws in California.
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