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San Jose Health Insurance

Facts and Figures

  • Insurance
    Carriers
    13
  • Number of
    General Doctors
    2489
  • Number of
    Hospitals
    7

Insurance Carriers

State Government Insurance Programs Offered

Pre-Existing Condition Insurance Plan (PCIP)


Covers broad range of benefits, including primary and specialty care, hospital care, and prescription drugs. There is an annual deductible of $15,000 in-network/$3,000 out-of-network, brand name Rx deductible of $500/$500, and an annual out-of-pocket max of $2,500

Medi-Cal California’s Medicaid Program


Medi-Cal: Must be a California resident. Offers health, dental, vision, and prescription coverage. Treatment for special health problems, like breast cancer, kidney problems, nursing home needs, and AIDS.

AIM - Access for Infants & Mothers


Comprehensive medical care for mother provided (not just maternity). Mothers continue coverage up to 60 days after delivery. After birth, infant is automatically enrolled in Healthy Families Program up to age 1.

Healthy Kids


Healthy Kids: Covers doctor's visits, Immunizations, Dental & vision care, Prescriptions, Surgery, and Hospitalization.

CaliforniaKids


www.californiakids.org Covers Medical (outpatient only), preventive, dental, and vision care, emergency room ($1,000 annual limit), behavioral health program (requires approval), and prescription drugs. Must be children ages 0–18 and going to school, not be eligible for other government plans such as Medi-Cal or Healthy Families Program

Kaiser Permanente Child Health Plan (KPCHP)


Hospital care, Hearing and vision tests, Laboratory and x-ray services for no charge. Doctor office visits, Prescriptions, Urgent care, Emergency visits, and Mental health care (outpatient 20 visits/year) for a fee.

Children Health and Disability Prevention (CHDP)


Covers Immunizations; dental, vision, hearing, and nutrition screening; tests for illnesses like anemia, TB and others as needed; health and tobacco education; WIC referral for children up to age 5. www.dhs.ca.gov/pcfh/cms/chdp

Medi-Cal California’s Medicaid Program


Medi-Cal: Prenatal, pregnancy, and delivery care. Mothers are covered up to 60 days after delivery.

Healthy Families


Physician, emergency and preventive care; prescription drugs; inpatient and outpatient (medical, mental, and substance abuse) hospital service; family planning and maternity care; medical transportation; durable medical equipment; physical, occupational, and speech therapy; x-ray and lab services; home health care and nursing care.

County Medical Services Program (CMSP)


Program availability varies by county; medically- necessary physician and hospital-related services; depending on county, may provide coverage for other services such as dental and vision; benefits vary by county.

Medicare


Medicare offers Part A, inpatient care in hospitals and rehabilitative centers; Part B, doctor and some preventive services and outpatient care; Part C allows Medicare benefits through private insurance, (Medicare Advantage); Part C includes Parts A, B, and C not covered by Medicare. Part D covers prescription drugs.

Heath Care Reform

young adults will be able to stay on our parents’ health insurance policies until the age of 26. It's one of the most important parts of recent health care reforms.

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