CA Health Insurance Options for Male Age 25

[jb60]

Just to chime in here: For a small group to work, it must have 75% enrollment of eligible people (not counting medicare). That means only 1 of the 4 at his office can have private insurance and the other 3 have to be on the plan.

This may be one of the pluses to the Obama plan: People can go where they want and work for whoever they want regardless of their medical condition.

If he were my client, I would advise him to: 1) Get a job where benefits are available, or 2) start his own company and get at least 1 20hr/wk employee and start a group.

That's all it takes.

Good luck to you & he.

 

[CALTCAgent]

Thanks for the response!

Just to chime in here: For a small group to work, it must have 75% enrollment of eligible people (not counting medicare). That means only 1 of the 4 at his office can have private insurance and the other 3 have to be on the plan.

This may be one of the pluses to the Obama plan: People can go where they want and work for whoever they want regardless of their medical condition.

If he were my client, I would advise him to: 1) Get a job where benefits are available, or 2) start his own company and get at least 1 20hr/wk employee and start a group.

That's all it takes.

Good luck to you & he.

Do you know when the Obama plan will be available and we will know the details on it?

Thanks again!

 

[DS4]

So this guy now lives in zip code 95129 (San Jose, Ca).
And, he has HealthNet PPO?
I don't see the problem.
This guy just stays on COBRA until something better comes along.

 

[CALTCAgent]

So this guy now lives in zip code 95129 (San Jose, Ca).
And, he has HealthNet PPO?
I don't see the problem.
This guy just stays on COBRA until something better comes along.

The problems:

1. COBRA will run out, I believe soon.

2. He is "out of network" since the plan is PPO from moms work in Texas and he now lives in CA

Do you see his "problems"?

He now says he is going to go back to Texas and get surgery. I think that makes the most sense to me.

Thanks again!

 

[DS4]

The problems:

1. COBRA will run out, I believe soon.

2. He is "out of network" since the plan is PPO from moms work in Texas and he now lives in CA

Do you see his "problems"?

1) If COBRA is going to "run out", "soon", then he is eligible for HIPAA guarantee Issue.
2) Zip 95129 is San Jose, Ca. I did a HealthNet PPO provider search, HealthNet.com , and found 1768 PPO providers , and, 4 acute care hospitals.

 

[CALTCAgent]

1) If COBRA is going to "run out", "soon", then he is eligible for HIPAA guarantee Issue.
2) Zip 95129 is San Jose, Ca. I did a HealthNet PPO provider search, HealthNet.com , and found 1768 PPO providers , and, 4 acute care hospitals.

1. He tells me he is "out of network" now with the doctors in this area. Are there Healthnet group plan PPO's that have a "local" PPO network, you can't use it anywhere in the country and still be in network? (possibly he has an HMO and doesn't know it?)

2. What/where are the details on the HIPAA guarantee issue? Does it cost more with less benefits?

Thanks again!

 

[DS4]

1) He probably has HMO coverage.

2) HIPPA GI ---->HIPAA Guaranteed-Issue Health Insurance For California Residents (California) - The David Fluker Health Insurance Agency - Gilroy, California - Serving California Residents Since 1995

 

[BellaVega]

I'm guessing that he has his own private practice? If he works for a firm, they should carry insurance. I think his best scenario right now is to get a job with a firm and get on their health insurance plan. When does the health care bill regarding pre-existing conditions go into effect?

 

[Dave020]

1. He tells me he is "out of network" now with the doctors in this area. Are there Healthnet group plan PPO's that have a "local" PPO network, you can't use it anywhere in the country and still be in network? (possibly he has an HMO and doesn't know it?)

Thanks again!

Health Net PPO uses "First Health" network for out of state PPO providers. It is Coventry's network that they borrow.

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