Exhibit 10.42a



                 AMENDMENT NO. 1 TO 1992 STOCK OPTION AGREEMENT


            This Amendment No. 1 to the Stock Option Agreement dated as of
       February 25, 1992 (the "Agreement"),  is  made by and between Peter
       J. Ratican (the  "Executive")  and  Maxicare  Health Plans, Inc., a
       Delaware corporation (the "Company") and  dated as of April 1, 1996
       (the "Amendment No. 1").

            WHEREAS, Executive has served as  Chairman of the Board, Chief
       Executive Officer and President of the Company since August, 1988;

            WHEREAS, the Company and  the  Executive  have entered into an
       Amended and Restated  Employment  Agreement  dated  as  of the date
       hereof which provides  for  certain  terms and conditions regarding
       the employment of Executive by the Company; and

            WHEREAS, the Company and the  Executive desire to make certain
       changes to the Agreement as set forth herein;

            NOW THEREFORE,  in  consideration  of  the  foregoing  and the
       mutual covenants and agreements contained herein, Executive and the
       Company hereby agree as follows:


            1.   Section 5 of the Agreement is hereby amended as follows:

                 (a)  to add in the  fifth  line of Subsection (a) thereof
       after the word "merger" the following:

                      "stock split, reverse stock split,"

                 (a)  To add  in  the  fourth  line  of Subsection (b)(ii)
       thereof after the word "transaction" the following:


                       ".        For     the    purposes    hereof,    the
                       aforementioned    economic     benefit    to    the
                       Executive  shall  be   calculated  (without  regard
                       to   the   illiquidity   of   the   Option  Shares)
                       based  upon  the   actual  difference  between  the
                       Option  Price  and   the   closing   price  of  the
                       Common Stock  on  the  last  trading  day  prior to
                       the    consummation     of     such     event    or
                       transaction."







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            2.   Section 6 of the  Agreement  is  hereby amended to add in
       the sixth line  of  Subsection  (c)  thereof  after "substance" the
       following:

                      "reasonably"

            3.   Section 9 of the Agreement is hereby amended to delete in
       the fourth line thereof "it".

            4.   Section 11 of  the  Agreement  is  hereby  amended to add
       after "by" on the second line thereof:

                      "virtue of the grant of"

            5.   Section 13 of the Agreement is hereby amended as follows:

                 (a)  Subsection  13.4   is   hereby   amended  to  delete
       "specified" from the ninth line and add the following in
       lieu thereof:

                      "specific"

                 (b)  A new Subsection 13.9 shall be added to
       Section 13 as follows:


                       "13.9      The   Jurisdiction,   Attorneys'   Fees.
                       The  parties  hereto   agree   that   any  and  all
                       disputes  hereunder   shall   be   submitted  to  a
                       court  located  in   Los  Angeles,  California  and
                       in  this  regard,  the   parties  agree  that  they
                       shall  consent  to  personal  jurisdiction  to  any
                       state  and/or  the  United  States  District  Court
                       for   the    Central    District    of   California
                       sitting  in  Los   Angeles,  California  and  agree
                       to  venue  in  the   State   of  California.    All
                       costs    and    expenses    (including   attorneys'
                       fees)  incurred  by   the   parties  in  connection
                       with    any    dispute     arising    under    this
                       Agreement,  shall   be   apportioned   between  the
                       parties  by  a   court   based  upon  such  court's
                       determination    of    the    merits    of    their
                       respective positions."


            6.   Except as expressly set  forth  herein,  all of the terms
       and conditions contained  in  the  Agreement  shall  remain in full
       force and effect.








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            IN WITNESS WHEREOF, this Amendment  No. 1 to the Agreement has
       been executed as of the date first above-written.



                                    MAXICARE HEALTH PLANS, INC.


                                    ---------------------------

                                    By:
                                       ------------------------

                                    Title:
                                          ---------------------


                                    EXECUTIVE


                                    /s/ PETER J. RATICAN
                                    --------------------
                                        Peter J. Ratican


                                    Title: Chairman of the Board,
                                           Chief Executive Officer,
                                           and President
                                           Maxicare Health Plans, Inc.
                                           ---------------------------

























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