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We recently adopted our son from Guatemala. He arrived in June and at that time, we added him to our group health insurance. They held claims on him until we finalized here in the state of Kansas. That was not a problem for us because the stated they would pay when they received the court documents. We finally received those documents and I promptly forwarded them to our Health Insurance carrier. Last week, I received a letter in the mail asking for documentation of previous health insurance on our son and also information on pre-existing conditions.
My question is does this apply to adopted children? I was under the impression that since he was a new addition to our family that we would not have to supply documention such as this. We acutally do not have this documentation. Of course, he was not covered by any health insurance previously. But, we also were not really informed of all medical issues with him as well. He was abandoned and 10 months old before we accepted his referral. He was 23 months old before he arrived home. I have no idea what to tell our insurer. Any help that you can give would be greatly appreciated.
Thanks
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I don't know if its Federal or state law, but I know in our state(MO) they can't do that. Insurance companies tend to be unaware of the law and you have to tell them that adopted children have the same rights as a newly born child. Usually, they just aren't informed. Anybody know if that varies by state or if it's federal?
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There is a federal law, the Health Insurance Portability and Accountability Act of 1996 (also known as the Kennedy-Kassebaum bill or P.L. 104-191), that addresses this issue. It bans group health insurance carriers from using pre-existing condition limitations to exclude newly adopted children from coverage.
Insurance policies used to be able to require "waiting periods" before any pre-existing conditions were covered for adopted children. The HIPAA says that pre-existing conditions must be covered, and that a limitation on pre-existing conditions cannot be applied, as long as the child has been placed on the insurance plan within 30 days of adoption or placement for adoption.
Parents must be sure to give written notice to their insurance carriers of their newly-adopted child(ren) within 30 days of adoption. Parents should keep a copy of the notice, and may want to get a certified, dated mail receipt. Further, parents should be sure to carefully review any requirements of their particular health plan.
In terms of COBRA coverage, the law allows parents to get coverage for their newly adopted children without having to wait until the open enrollment period. Further, the law has "portability provision" to protect children even when the parent changes jobs and insurance plans.