California Residents and HIPAA

HIPAA (the Health Insurance Portability and Accountability Act) is designed to help healthcare consumers who might otherwise find themselves unable to purchase individual health insurance due to a pre-existing medical condition. California residents need to know their rights under this important act so that they do not find themselves without coverage.

In order to be eligible for the protection of HIPAA, several requirements must be met. Importantly, you must have been insured under a group health insurance plan sponsored by your employer for a minimum of 18 months. This period can include time during which you were using COBRA or Cal-COBRA eligibility to qualify for coverage. You need to have completely depleted your COBRA and Cal-COBRA eligibility – that is, if you were eligible to continue your health insurance under either of these programs, you must have done so until such eligibility ended.

Other conditions precluding HIPAA eligibility include being eligible for or participating in any other group health insurance program, and/or having lost your previous benefits because of fraud or because you did not pay the premium.

California residents, like all Americans who meet these prerequisites, are protected from being denied coverage by a health insurance company due to their current health or medical history. Consumers who are confused about their rights under this Act or who need more information can contact the California Department of Insurance or the California Office of HIPAA Implementation. The Internet can also be a good source of information about HIPAA eligibility.

While HIPAA can be a big help for California families facing losing their health insurance coverage, it is important to be proactive about exercising your rights under the Act.