Los Angeles Wildfires and Health Insurance

The Palisades and Eaton Fires, as of the time of this writing, have burned tens of thousands of acres and destroyed thousands of structures, including many homes, businesses, and schools in the Pacific Palisades and Altadena. Those who have been displaced are just beginning to pick up the pieces to determine how they will go on and where they will live in the meantime. At the same time, many are coping with the health effects of being exposed to wildfire smoke and unsure that their medical insurance will provide the coverage they need to get treatment. Those who have previously gone without insurance may be terrified that they will be facing uninsured medical costs on top of the expense of trying to find new housing and rebuild from nothing.

Understanding the protections California law already provides and those that have been extended in the wake of the fires can help put some of those fears to rest. Here’s what to know.

Open Enrollment and State of Emergency Special Enrollment Period

Covered California’s normal open enrollment period runs from November 1 to January 31. In addition, however, the state of emergency declared in Los Angeles and Ventura counties means that Californians in those areas may qualify for a Special Enrollment Period (SEP) that allows them to enroll in a health insurance plan through March 8, 2025. Being in a “county under a state of emergency” is considered a Qualifying Life Event (QLE), in this case with a date of January 7, 2025.

What Health Insurance Is Required to Cover in California

California law requires certain basic health care services be covered under your health plan, but only mandates that care be covered when it is medically necessary. Covered services include:

• Doctor and hospital services, including inpatient and outpatient services
• Laboratory tests to diagnose problems, such as blood tests
• Diagnostic services such as X-rays
• Mental health care
• Emergency and urgent care services, even if you are outside your health plan’s service area

As of 2019, California no longer allows the sale of short-term limited duration health insurance policies, bare-bones health plans that do not meet the terms of the Affordable Care Act. Every plan is required to cover preexisting conditions, such as asthma that has been aggravated by smoke exposure.

If you are dealing with physical or mental health effects from the fires and have had a claim for care denied by your insurance company, the first step is to file an appeal with your insurer. Include documentation that supports the medical necessity for the care you received and its link to wildfire exposure. You can also obtain help with appeals by contacting the California Department of Managed Health Care (DMHC) or the California Department of Insurance.

Other Alternatives for Obtaining Help

In the wake of natural disasters, government programs may provide the means to access medical care and cover medical expenses for those in serious financial need. For example, Medi-Cal provides comprehensive medical coverage for those whose income qualifies and can be applied for at any time of the year. Organizations like Cal OES (the California Governor’s Office of Emergency Services) and FEMA (the Federal Emergency Management Agency) often provide health and financial aid during natural disasters as well. It’s important to note that those seeking plans through Covered California may also qualify for subsidies to offset the cost of premiums, so it is worth exploring all available options.

For immediate care, many community health centers and clinics provide free or low-cost care during emergencies, particularly for conditions like respiratory problems. Those resources can be invaluable for those without coverage who need treatment as they look for ongoing coverage to protect their health.

Helping You Find the Right Health Insurance Coverage

If you have been impacted by the Los Angeles wildfires and need to either obtain health insurance coverage or change your existing coverage, Medical Insurance Today can help. As a Covered California Enrollment Center, we can not only match you with an appropriate plan and coverage level but also help you qualify for all the financial assistance you’re entitled to. Our agents will explain everything you need to know in plain language—English or Spanish—to give you the peace of mind that you are picking the right coverage for you. When your life has been turned upside down by disaster, you shouldn’t have to worry that you can’t get the medical care you need. To get started, contact us here today.