So my social worker at California Children’s Services (CCS) called a while back after I’d turn 18 to talk about some medical stuff. One of the things she mentioned was checking in with my insurance company (HealthNet, under Covered California) to let them know that I would be moving to another county due to college. Is this something that you as a parent did for your child? What were your experiences? Did you have to switch plans? What should I be expecting wrt the college transition + insurance?
(-I checked and HealthNet does cover the county that I’m moving to so I probably won’t be switching plans, I think.
-I’m not buying my college’s health insurance because it’s too expensive.
-I will call my insurance company, but I just want to get my bearings. I hate phone calls bc I’m hard of hearing so I’d like to hear more about people’s experiences first.)
There are so many plans within insurance companies that it’s not possible to know about your specific one but, as long as Health Net covers your new county, you’re likely to be fine. You will, however, need to select a new (local) primary care physician in your new area. Hopefully, there won’t be a rate increase.
Good idea above about asking your social worker to call on your behalf, if permitted. I just checked to see if Health Net offered live chat or email but couldn’t find either. Unfortunately, it seems that calling is the only option. Good luck.
Our kids remained covered under our family plan until they aged out. Originally, S aged out when he reached 22, but then it was raised to age 26 under ACA, so after having to cover him for a year, he was able to go back on our plan until age 26. Our insurance covers us all anywhere in the US, with best benefits if in network providers are used.
Each policy differs, so the terms have to be read. Our kids were covered with our HI policy in HI, CA, VA and wherever they or we are. There is less coverage when we are out of country.
I agree that your social worker should be able to help you navigate this and be sure you have coverage in the county where you are going to attend college. Actually, often colleges provide good insurance at reasonable prices, so that is something to seriously consider as well.
Thanks everyone for your help! I would ask my social worker to call for me, but CCS is akin to a public insurance company so it’s probably not her job to call. (They pay for certain medical treatment if my insurance doesn’t and connect me to doctors in my area.)
I called HealthNet today and the customer service rep said that I didn’t need to change anything (address or PCP) since I wouldn’t be permanently moving. Which I thought was weird because both the CCS lady and the insurance administrator at my college said I would need to change both. I’ll probably call again tomorrow to make sure… sadly the number for HoH folks doesn’t seem to work (I just get weird beeping noises).
Health Net may now offer plans other than an HMO (health maintenance organization) but, at one time, they only offered them. Under a very common HMO model, you sign up with one PCP who is a part of a particular medical group. That medical group receives a capitated amount (a set, per member per month dollar amount) to cover almost all of the services you receive outside of a hospital (doctor visits, lab work, xrays, etc.). You are required to receive all of that type of care through that medical group (since they receive money from the HMO–Health Net–to provide that care for you).
Thus, it surprises me that you aren’t required to pick a new PCP near your college. When you call back, you may want to ask if you may see any doctor in their network if you need care when you are at college, regardless of medical group. I would think that your current medical group (the group your current PCP is affiliated with) would not accept claims from another medical group for care they can provide for you.
It is possible that Health Net now offers different types of benefit plans but, at least at one time, this was the only option available. It’s also possible that college students fall into some special category that is treated differently but I would definitely confirm which providers you can go to near your college if you need care and can’t get back to your current PCP.
Thank you for explaining all that to me! I’m under an HMO plan and I plan to switch to PPO in the next two years as my Medi-Cal coverage expires (I know I mistakenly mentioned CoveredCA before). Even though I’m under an HMO plan, there’s a lot of Health Net doctors in my college’s county so hopefully I’ll be fine.
I called the Health Net Medi-Cal line again today and they confirmed that I needed to switch my Medi-Cal coverage location and my PCP. They gave me another number to call. Now that I understand what’s going on, I think the rest will be relatively easy.