Health Insurance for Adopted Children

When it comes to insuring adopted children, laws and regulations vary widely depending on what type of coverage the adoptive parents will be using to cover the child. Some insurance plans are covered exclusively by Federal regulations while others are subject only to state laws. Here are a few things parents should know.

Group Coverage

If one or both parents are already insured on a group-rate or employer-based insurance program, then they can look at federal statues and regulations to determine what kind of coverage their child is guaranteed. Federal law established in the Omnibus Budget Reconciliation Act of 1993 requires insurance companies to provide the same coverage options to adoptive children that natural children would receive. This applies equally to international adoptions as well as children adopted from within the United States.

Start Dates

One important and often misunderstood element of insurance coverage and adoption is the date that coverage starts. Federal law includes a protection for adoptive children that guarantees coverage from the date the child is placed for adoption. In the case of newborn babies, this may include any hospital expenses accrued on their date of birth. This is good news for parents adopting brand new and premature infants. However, some companies may deny this coverage, so always check with your provider before budgeting for this expense. As long as a child is enrolled within 30 days of adoption, retroactive coverage is guaranteed.

Individual Coverage

Individual coverage, that is, insurance that is purchased on an individual basis instead of by an employer or group, is governed by the state in which the policy holder lives. Each state has its own regulations, some of which can vary widely. If you have this type of insurance and are planning on adopting, the best approach may be to speak to your insurance agent directly to find out what the company does and does not include in their payment. However, there is sufficient legislation to guarantee coverage in most circumstances, so if your insurance refuses to cover some costs, be certain to look up the specific legislation that relates to your situation.

Medicaid and IV-E Assistance

Medicaid is available for adopted children who have special needs. Additionally, the adoptive parents of children who come from foster care may be eligible for extra financial assistance under Federal title IV-E. This assistance may include one-time or ongoing help, depending on the child’s requirements as well as the parents’ insurance and ability to purchase coverage for the child. The title was intended to minimize financial barriers to adoption and help more children in foster care find permanent homes.

Insurance Enrolment

Regardless of the type of health insurance you intend to purchase for your adopted child, be sure that the child is enrolled within 30 days of the adoption date to ensure proper coverage. Insurance companies may be able to deny coverage to or exclude children from your health insurance policy if they are not enrolled within that time frame.

When dealing with insurance companies, make sure that you know your rights. Being prepared, proactive, and informed will help the transition into life with your newly adopted child go smoothly.