4280 Managed Risk Medical Insurance Board
Program Descriptions

4110 - MAJOR RISK MEDICAL INSURANCE PROGRAM

The Major Risk Medical Insurance Program provides health coverage to residents of the state who are unable to secure adequate coverage for themselves and their dependents because insurers consider them to be ''medically uninsurable'' or at high risk of needing costly care. The program procures coverage for subscribers through participating health plans. Subscribers pay monthly premiums and the program subsidizes the remaining costs. Effective July 1, 2014, this program was transferred to the Department of Health Care Services.

4115 - ACCESS FOR INFANTS AND MOTHERS PROGRAM

The Access for Infants and Mothers Program provides comprehensive health care to pregnant women. Only pregnant women whose family income is between 200 and 300 percent of the federal poverty level are eligible for the program. Pregnant women with incomes below 200 percent of the federal poverty level are eligible for the Medi-Cal program. The AIM Program provides coverage through participating health plans and covers eligible women through their pregnancy and 60 days postpartum. Subscribers pay a premium equal to 1.5 percent of their family income and the plan subsidizes the remaining cost of coverage. Effective July 1, 2014, this program was transferred to the Department of Health Care Services.

4120 - HEALTHY FAMILIES PROGRAM

The Healthy Families Program provides health coverage for eligible children up to age 19 in families with incomes up to 250 percent of the federal poverty level. These children are not eligible for Medi-Cal because of income. The program provides comprehensive health, dental and vision benefits through participating plans. Families pay a monthly premium and the program subsidizes the remaining cost of coverage. Individuals in the Healthy Families Program transitioned into the Medi-Cal program administered by the Department of Health Care Services beginning January 1, 2013.

4125 - COUNTY HEALTH INITIATIVE MATCHING FUND PROGRAM

The County Health Initiative Matching Fund Program provides health coverage for eligible children up to age 19 in families with incomes between 250 and 400 percent of the federal poverty level that are not eligible for Medi-Cal or the Healthy Families Program. Coverage is provided through county-sponsored insurance programs, which provide comprehensive benefits similar to the Healthy Families Program. Program costs are funded by matching county expenditures with federal funds in participating counties that have been approved by the federal government. The Managed Risk Medical Insurance Board manages the intergovernmental transfer of federal funds, and the counties administer the program. Effective July 1, 2014, this program was transferred to the Department of Health Care Services.

4130 - PRE-EXISTING CONDITIONS INSURANCE PLAN PROGRAM

The Pre-Existing Conditions Insurance Plan Program is a federally-funded health coverage program which provides health coverage to medically-uninsurable individuals with pre-existing conditions. The program is only available for individuals who did not have health coverage in the six months prior to applying. Subscribers pay monthly premiums and the program subsidizes the remaining costs. Effective July 1, 2013, this program was transferred to the federal government.