California Major Risk Medical Insurance Plan (MRMIP)

→ View the MRMIP handbook

Guaranteed Health Insurance Plan

As a HIPAA eligible enrollee you are guaranteed the right to buy an individual health insurance policy from the California Major Risk Medical Insurance Plan (MRMIP).. Note:

• MRMIP prohibits pre-existing condition exclusion periods and elimination riders
• MRMIP is your only guaranteed source of individual health insurance

HIPAA Eligibility

To be HIPAA eligible in California, you must:

1. Have 18 months of continuous creditable coverage, with at least the last day under the Brethren Ministers Group; and
2. Not be eligible for Medicare, Medicaid or a group plan; and
3. Apply for health insurance for which you are HIPAA eligible within 63 days of losing your prior coverage; and
4. Not have health insurance.

Note: If you know your group coverage is about to end, you can apply for coverage for which you will be HIPAA eligible.

How much does MRMIP coverage cost?

MRMIP charges different premiums based on the plan chosen, geographic area of residence, age and gender. California law caps the premium at 125% of what a healthy person would pay for a similar plan sold by a private insurer. Click here to view MRMIP plan rates (details on p. 18).

MRMIP Coverage Highlights

• $750,000 lifetime maximum benefit; $75,000 annual maximum benefit. Note:Individuals must leave the program after 36 months. They are then guaranteed individual health insurance coverage with a new annual benefit limit of $200,000 and a new lifetime benefit maximum of $750,000.
• No deductibles; $2500 maximum annual out of pocket (in Network)
• Both PPO & HMO plans are offered, based on zip code
• Benefits include hospital, physician and nursing care, prescription drugs; Maternity coverage is available for an extra premium
• For complete details, view the California MRMIP Handbook

How can I be insured with MRMIP?

For enrollment information visit the MRMIP website at www.mrmib.ca.gov or call them at (800) 289-6574.

Special insurance for children: Healthy Families

A family of three making up to $42,936 a year may be eligible for Healthy Families.

• Do you qualify? Visit Eligibility.
• Questions? Visit their FAQs, or call (800) 880-5305.