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Individual Health Insurance


There are many different types of California individual health insurance plans in the marketplace.  It is our job to make the process as simple and efficient as possible. 

To start researching the right plan for you, please click here.

Individual Health Insurance Facts

Here are some basic facts about individual health care in California:

  • In 2010, over 2.5 million people applied for and received individual health insurance
  • 7.5 million people have coverage through Medi-Cal
  • Almost 9 million Californians do not have health insurance

The Process Of Getting Individual Health Insurance

Getting individual health insurance in California is a simple process but not as simple to get approved.  After you complete the application process through one of the large carriers such as Anthem Blue Cross, Blue Shield, Aetna, Assurant, Kaiser and HealthNet; you have to go through the underwriting process.  Sometimes you are approved right away if you are very healthy.  Other times, carriers such as Anthem Blue Cross and Blue Shield might ask for medical records or even a telephone interview.  It is up to each individual health insurance carrier to decide whether or not to approve you for health insurance coverage.  All health insurance carriers are different and they also have different underwriting guidelines.  Health insurance carriers also rate each applicant in tiers.  If they deem the health insurance applicant to be risky, they might approve the application but at a higher premium.  Health insurance carriers in California all have different criteria on how they rate each applicant.

We can help you determine your feasibility of getting approved for individual health insurance.  Please give us a call at 888.662.8254 and we can help.

If you have a pre-existing condition and were denied health insurance through the traditional private market, you can apply for health insurance through the California High-Risk Insurance program.   

The State of California offers a high-risk pool program for consumers who might not qualify for traditional private health insurance.  This program was set up primarily for individuals who have pre-existing conditions.  Their are certain qualifications that must be met before you could apply for insurance through this program. 

To learn more about the program and if you would qualify, please visit the Managed Risk Medical Insurance Board website. 

When Should I Apply For Individual Health Insurance?

  • You do not have coverage anywhere else and need the coverage
  • You are self employed
  • Your employer does not offer health insurance
  • Your employer does not cover spouses or dependents
  • Your current health insurance plan is too expensive
  • Your current health insurance plan does not have the right benefits

Which Carrier Should I Choose?

Each carrier in California has their different strengths and weaknesses.  You can visit our health insurance pages to read more about the history of each carrier and which plans they offer.  Each health insurance carrier offers different plans that has different variations of network, deductibles, co-pays, prescriptions drug benefits, etc.  

Below is a quick snapshot of some of the large carriers we work with:


  • Has about 40 million members
  • Aetna provides medical insurance, dental insurance, Medicare coverage, and other insurance products
  • Established over 150 years ago

Anthem Blue Cross of California :

  • Nearly 80,000 physicians in California
  • Access to health insurance in all 50 states
  • Established in California over 70 years ago

Blue Shield of California:

  • 3.5 million members in California
  • Nearly 54,000 physicians and over 360 hospitals within their network in California
  • Founded in 1938


  • Founded in 1978
  • Over 500,000 health care providers nationwide
  • Based out of Chicago, Illinois


  • Been in business for over 200 years
  • Has over 36,000 doctors in California on their network
  • Serving 500,000 doctors and 8,000 hospitals and facilities nationwide


  • Does business in 27 US states
  • Over 6.6 million members nationwide
  • One of the leading behavioral health service companies in the country


  • One of the largest manage care companies in the U.S.
  • One-stop delivery model through their hospital network
  • Access to PPO network through Multiplan

Consumer Guide To Individual Health Insurance

This is a great resource for consumers to learn more about individual health insurance and all related services.  Please visit the Department of Insurance consumer resource page to learn more about:

  • Types of Health Insurance and How it Works
  • COBRA vs Cal-COBRA
  • Consumer Inquiries and Complaints
  • Health Insurance Options
  • Health Insurance Terms

Learn More About:

California Insurance Carriers We Work With:

Health Insurance Exchange

Starting in 2014, states will be required to have health insurance exchanges up and running.  The main goal of these exchanges will be to provide affordable health insurance to all Americans.  Read more here.

In The News: Individual Health Insurance


November 18th, 2011:

What Issues Will The Supreme Court Decide On The Health Care Law?

Americans are waiting to see what the Supreme Court will do when they review the health care reform laws in March.  This will be a big moment for the American people and the Obama administration.  This has been Obama's main initiative since he took office.  Now that it is before the Supreme Court, everything could be in jeopardy.  They will be reviewing whether or not it is constitutional, the jurisdiction rules, management of the whole process and expansion of Medicaid.  Hopefully the decision will lead to making health insurance more affordable. 


October 4th, 2011:

Recession A Major Factor In Shift To Public Health Insurance

Because of the recession and people losing their jobs, many individuals have been forced to get health insurance from the public markets.  Additionally, they can not afford insurance without the help of the government.  The health reform is supposed to make health insurance more affordable for individuals, and it could not come at a better time.  We have to wait until 2014 to see the full effect of the new reform.


September 9th, 2011:

Back-Up Plans For The Individual Mandate?

Many experts are wondering what will Americans do if the individual mandate is overturned before 2014.  The health reform law is requiring that all Americans have health insurance by 2014, or they will face fines by the government.  Many states have been fighting the mandate in state courts hoping to get it overturned.  People opposed to the mandate believe that requiring everyone to get health insurance is unconstitutional and having the states run health insurance exchanges will be too costly.


August 19th, 2011:

Best To Rule On Health Care Act Now

Atlanta courts recently ruled that it is unconstitutional to require individuals to have health insurance against their will.  Obama's Affordable Care Act is most likely going to have to be settled in Supreme Court.  Many states are opposed to the legislation, stating that it is unconstitutional.  The Obama administration wants to provide affordable health care and insurance to all Americans.  In California alone, it is estimated that 8 million people will benefit from the health insurance exchange in 2014. 

Many experts claim that the reform will actually increase health insurance premiums as unhealthy Americans will take advantage of the system and adverse selection will drive up rates. 


August 12th, 2011:

Health Insurance During Early Retirement

Many baby boomers are starting to enter early retirement, and many face the large challenge of finding health insurance before their Medicare kicks in.  Health insurance coverage is very expensive, especially when you start to get older.  One of the main factors of determining the health insurance premium rate is age.  That is because the older you get, the more claims on average go through the system.  Coverage for early retirees is a challenge because the health insurance premiums are just too high.  


July 28th, 2011:

Health Spending Expected To Grow Faster Than GDP

Healthcare spending is expected to grow at a rate of 5.8% per year over the next 10 years.  That is faster than the economy is expected to grow over the same period of time.  The GDP is expected to grow at a rate of 4.7% over the next ten years. 

The main driving factor in the increased healthcare spending is the private health insurance market.  Because the economy continues to struggle, many people lost their employer-sponsored coverage and are forced to get private health insurance.  This drives up the cost of healthcare and the related services around it.  When the private market peaks, many predict that spending will get out of control and the health reform may not help.


July 21st, 2011:

Changes To Medigap Coming?

Government spending and the budget have been large focal points over this past year.  With the new health reform laws slowly taking form, many changes to Medicare and the supplement plans that come with it are inevitable.  As the economy continues to struggle, government officials are going back and forth on how much they will possibly be cutting the Medicare program.  Many are trying to push more of the health care costs onto the baby boomers that are starting to retire.

Predictions are that Medigap plans, the supplement insurance that some seniors get on top of Medicare, will be rising in cost as well.  Many people are without health insurance and are simply waiting until they are eligible for Medicare.  The risky part is that Medicare is not what it used to be.


July 5th, 2011:

Prices Drop For High-Risk Insurance

The Obama administration announced last Friday that health insurance premiums for high-risk individuals will be dropping very soon.  The health insurance premiums are estimated to drop an average of 40% in 17 different states.  Individuals that cannot get coverage from the private health insurance market are forced to get insurance from high-risk pools where insurance is targeted towards people with pre-existing conditions. 

The administration is hoping this will trigger more individuals to apply for insurance, both in the private market and high-risk pools.  By 2014, all individuals are mandated to obtain health insurance and no one can be denied health insurance because of a pre-existing condition.



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