Not really an international adoption, but the question certainly applies. My wife and I are adopting an 8 year old girl. She is a Mexican illegal alien. She was removed from her birth family because of physical abuse about 4 years ago. The D.S.S. has started the process of gaining citizenship for her. How long can we expect this process to take? In our state, North Carolina, kids in the state system are entitled to Medicaid, but she is not covered because of her alien status. Luckily she is healthy, but if she becomes ill before the adoption is finalized, we may be in a scrape. Once the adoption is finalized, I can put her on my health care plan through work (I think).
Thanks for any help you can provide.
The Health Insurance Portability and Accountability Act of 1996 may apply to your situation if you are covered by GROUP (not individual) insurance, and if your employer has at least two people covered under the plan.
Under the Act, any child who was either adopted by you OR PLACED FOR ADOPTION with you must be covered by your insurance as of the date of adoption or placement for adoption by you, without any waiting period or limitations on coverage for pre-existing conditions. It doesn't matter whether the child was adopted internationally or domestically, whether the child has yet become a citizen, or whether you were given the child under a decree of guardianship and are waiting to finalize.
The only rule is that you MUST notify your employer within 30 days of the child's adoption or placement with you for adoption. Otherwise, this law does not apply.
Your employer and/or insuror will probably need proof of the child's placement with you and of her date of birth.
The employer/insuror may also require you to provide a SSN for the child. SSNs can be obtained for any child who has been legally adopted OR PLACED IN YOUR CUSTODY for adoption, whether or not the child has yet become a U.S. citizen. However, getting one can be difficult in a case like yours, where the child is an illegal immigrant. DSS should be able to advise you on whether you can get one or whether you should apply for the ATIN, which is usable in some domestic adoption cases and which should satisfy your employer/insuror.
I hope this helps.
Thanks for the reply. I was unaware of that information. I will follow up with my employer for sure. We are covered by a group plan, so that does help.
The DSS was really not much help, this is their first time dealing with these issues, and they were up front with that. It will be a learning experience for all involved.
Thanks again.
Do be aware that most HR departments and some lower level insurance people don't have a clue about the Health Insurance Portability and Accountability Act. Even people with very "ordinary" domestic or international adoptions have run into problems getting their children added to their policy. You WILL have to do some work, unless other people at your company have adopted and dealt with this issue previously.
One thing you can do is to go to and print out a copy of the law, which was passed in 1996. It addresses many different issues, in addition to adoption, so highlight the relevant sections. Then give them to your HR person.
Another thing you can do is to contact the insurance company and ask to talk to someone who is familiar with HIPAA and its provisions with regard to adopted children.
You do not need to mention that the child was an illegal immigrant. For the purpose of getting benefits, all that matters is that she is a ward of your state, and has been placed with you for adoption. All that needs to be considered is that she was legally placed with you by your state government less than 30 days ago, and remains in your custody. When her adoption is final, you will notify your employer to that effect.
If you get a lot of woofs from your employer/insuror, call a local attorney who is familiar with HIPAA and its implications for adoptive families. He/she may be able to send a letter to your employer/insuror and clear up the matter.
That is some great information Sharon. Thanks a ton! I'll be sure to keep you posted on my efforts.
I found the Act and I can see where she would qualify as a ward of the state. In your first reply, regarding SSN's you mention an ATIN. Does that stand for Alien Tax Identificaion Number? If so, I know she has that. Maybe this won't be so bad after all. I work for an international company, so they are keen (I hope) on insuring people who are not US citizens. Thanks again, you have been very helpful.
Well, I went to HR today and explained that I was adopting and the youngster will be placed Friday. They said no problem, as long as you notify us within 30 days of placement, she could be added on. I asked if that applied to a non U.S. citizen, and they replied "as long as she is ward of the state, it doesn't matter." So my HR department is truely on the ball.
Thanks again for the help.
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