First of all, she may be eligible to continue her current insurance, at her own cost, under federal COBRA. She should check with her former employer.

In California, it's like everywhere else: you either get insurance through your employment, or you buy it individually, in which case you get it through an insurance broker who sells health insurance.

If she wants an HMO, she can buy that too. They are very popular here. But if she has any type of chronic health problem, I wouldn't recommend it.

There are limited protections for consumers in California, since under federal law, group insurance (procured through employment) is covered under ERISA (the Employee Retirement Income Security Act of 1974), and all state laws governing group health insurance claims, etc. are pre-empted. It's been that way since 1987 (thanks, Supreme Court!) so they have virtual free reign to do whatever they want. Don't get me started.

However, there are all the usual sources for information on the web. For HMOs, they are licensed under the Department of Corporations. More traditional programs are regulated by the Department of Insurance. Both have consumer information. There is a process for review if an insured seeks treatment, is denied coverage, and wants to appeal. Otherwise, in purchasing insurance, buyer beware.

Here is a link that might be useful: California Dept. of Insurance

Thank you so much Debra. It is discouraging to have to make a decision when an industry is so powerful. She seems to need Physical Therapy and Accupuncture as much as a medical doctor, and to get that if she is not employed seems almost impossible.

Sammy

Sammy,

FWIW, I just received my COBRA paperwork from the last employer. The cost to continue, at my own expense, is a few dollars short of $900/month. Fortunately, I have coverage.

Over the weekend the newspaper published an article citing the annual premium in California (average/self paid) as around $11,000 yearly, assuming eligibility.

The main problem they may face is that if any lapse in coverage occurs, regardless of brevity, then they'll be (probably) excluded for at least a year on the basis of the headaches being a "pre-existing" condition. Continuity in coverage with no gaps is vital to prevent this from occurring.

If they anticipate a break in employment/coverage they can shop for the absolute cheapest/basically useless/high deductible policy they can find. These will be expensive but significantly less so than continuing via COBRA. The advantage of doing this is that it will provide continuity in coverage and prevent the new insurance plan at the new employer from denying headache coverage for one year.

Good luck.

MichaelAT

Just so you know, there are some regulations and laws that restrict the insurer's ability to exclude pre-existing conditions here in California. If she gets group coverage, none of that matters, she's eligible no matter what, once she satisfies the waiting period (between 30 and 90 days) during which she can maintain her COBRA.

Rates depend on age and place of residence, although health history might play a role. She's young, but whether that offsets her health history I do not know.

I also converted my family's health plan to COBRA when I left my last job. Coverage for a family of 5 came to about $900 a month, with us being old(er). I never liked the coverage, so we bought a new group policy for our new law practice which costs the same, but which provides much better coverage.

One hint: the agent should do some calculations to see whether the premiums are better with your daughter as the primary named insured (and her husband as the "spouse") or vice versa. We did this, and discovered that because I'm 10 months older than my DH, it was cheaper for me to be a "spouse" than to keep the coverage in my own name, with him as the dependent, even though he has serious chronic health problems and I have none. I have no idea why.

This may help:

How Is Health Insurance Marketed in California?
Health insurance coverage is marketed to consumers through individual policies or group policies. Individual health insurance coverage should be pursued when your employer does not offer health insurance as a benefit of employment, when you cannot be named as the dependent on another personÂs insurance policy, or when you are not a member of a professional or trade association that offers group coverage. Many consumers are self-employed, contract employees, or work for small employers and do not have access to a group policy secured by an employer. Individual coverage can be obtained by contacting a licensed health insurance agent or broker. You will need to complete an application that includes your medical history, which will be reviewed by a medical underwriter at the health insurance company. If you meet the underwriting qualifications and are issued a policy, the company may not cover preexisting conditions up to one year after the effective date of the policy. However, if you have been previously insured under an individual or group policy without a break in coverage of more than 62 days, your new insurance company must apply the prior creditable coverage (refer to the "Health Insurance Terms" on page 15) towards any waiting period for preexisting conditions. Individual health insurance companies may reject your application based on your medical history.

Group health insurance offers certain advantages over individual health insurance policies. The waiting period for preexisting conditions is six months, not one year as with individual policies. Also, if you have been previously insured under a group policy without a break in coverage of more than 180 days, your new insurance company must apply the prior creditable coverage toward the six-month waiting period for preexisting conditions. Large employer group health insurance (more than 50 employees) and association group health insurance, like individual health insurance, is subject to medical underwriting. You can be denied coverage based on your medical history. Medical underwriting rules for small group health insurance (2-50 employees) differs from large group and individual health insurance policies. Regardless of any preexisting condition, you must be offered coverage under a small group policy on a guaranteed issue basis. However, the small group insurance company can utilize the six-month waiting period for preexisting conditions. Of course, if you have prior creditable coverage it must be applied to decrease or eliminate the waiting period.

CA.Gov

Every year I seem to receive a notice that my health insurance premiums are going up. While

this doesn't surprise me, the amount that it increases does shock me. Upon my next renewal,

my quarterly payment will go up about $200. I am now paying more than twice what I

originally paid when I first bought this policy about seven years ago, and I've even cut

back on benefits significantly over the years. In seven years time, I'm paying more than

double and receiving less coverage.
I checked some quotes at [URL=http://www.oneshopinsurance.com.com]Onseshopinsurance[/url]

and was able to check on several premiums I can afford.

Hope this helps.

Here is a link that might be useful: One Shop Insurance