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Health Insurance Coverage For An Adopted Unhealthy Child

Armen Hareyan's picture

The implications of health insurance policy when adopting a child with health problems.

Q: I am adopting a child with health problems. Will I have trouble adding him to my health insurance policy?

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Whether the child you are adopting has health problems that can be corrected with proper treatment, or has a medical condition that will require ongoing care, you may be concerned that your health insurance provider will refuse to cover your child because of his pre-existing condition. However, if you have group health coverage, take heart. The Health Insurance Portability and Accountability Act of 1996 bans group health insurance companies from excluding newly adopted children from coverage because of pre-existing conditions. The law also includes a "portability provision." If you change jobs and enroll in a new group insurance plan, the new insurance company must cover your adopted child.

Check with your health insurance provider, though, to make sure that the treatment the child will require is covered under your policy. If the provider does not normally cover the treatment for you or your naturally born children, it will not cover that treatment for your adopted child. Moreover, you generally must add your child to your health insurance plan within 30 days of either the adoption or the placement for adoption. Otherwise, your health insurance provider may deny coverage. You can usually do this by calling your health insurance company or informing your employer's human resources department. If your child is hospitalized when you legally adopt him, call right away to ensure that all medical claims are paid.

Reprinted with permission from Insurance.com