Hi All,
Some friends of ours recently adopted their daughter from Korea. She has some non-life threatening health issues, which they were aware of before she was adopted. Before finalizing, they checked with their insurance company (they are both self-employed and therefore buy private insurance) to make sure their daughter would be covered, and they were assured she would be. Well, when they brought her home, they were greeted with a letter from Golden Rule (yeah-ironic name) stating that Olive (their daughter) would not be covered BECAUSE SHE WAS ADOPTED.
Our local news did a story on their family and situation. They are trying to get national coverage on this issue, in order to change the regulations of the state of Missouri as well as get Golden Rule to change their decision and treat all children, regardless of whether they are bio or adopted, the same when it comes to medical insurance coverage.
Please take a few minutes to check out the text and video on their story, and leave some comments!
I have never heard of this...thank you for posting this. I honestly through that once a child is adopted they are treated as any child and they receive the same rights.
Has anyone else had this problem? We are in the research stage of adoption and this was the furthest thing from my mind. Does anyone know how Tricare works? (PM if you do)
YnotBhappy
08-27-2008, 08:02 AM
That is awful! It has been hard getting our baby added, but only because of paperwork. The "covered for 31 days" is the same just as a newborn for us.
TestifyToLove
08-27-2008, 08:20 AM
Private health insurance is not legally required to cover pre-existing conditions on adoptees. If you have group health insurance (what most people recieve through their employers) then Federal law mandates that they MUST cover the adoptee 'as if they were born to you'.
That's probably why you haven't heard of this before. Most people have group health insurance and its a non-issue.
However, those who still have private health insurance still contend with the loophole that insurance companies do not HAVE to cover the child under those policies. Its stinky. And, I think its incredibly stinky that this company lied to this family in the first place and sprung this on them after homecoming. In fact, iirc the Class B Waiver for medical conditions requires that you list what insurance coverage you have for the child, so the company caused the parents to unknowingly lie on a federal immigration form.
I don't think this family has any legal recourse for this. Its possible if the insurance agency put it in writing that the child was covered they might. But, Federal law intentionally doesn't address individual insurance policies. Someone might need to go back to coporate work to gain group health insurance and then wait the year for the pre-existing clause to pass if its possible. The only other really viable option is to apply for state insurance for the child, but most states require a 2 year residency before you can qualify for state insurance benefits.
Trust me, I understand how vital health insurance is in adopting medical needs children. But, Dh cannot pursue a career in self employment for this very reason, we have 2 highly medical needs children who require the protection of group health insurance. So, he works corporate jobs to keep our children with the health insurance they need for their medical needs.
mom55
08-27-2008, 08:33 AM
What an eye opener. We have four children we brought home from Korea and never had any issue with insurance coverage.
What an unjust situation!
JenS
08-27-2008, 04:36 PM
I hate private insurance for this very reason. While our carrier covers an adopted child we were forbidden to pursue adoption in our first year of coverage. It's just NUTS! Some will altogether deny a family who is in process of an adoption. The whole family! It is part of the questionnaire for the coverage application.
Kori
08-27-2008, 05:28 PM
Private health insurance is not legally required to cover pre-existing conditions on adoptees. If you have group health insurance (what most people recieve through their employers) then Federal law mandates that they MUST cover the adoptee 'as if they were born to you'.
That's probably why you haven't heard of this before. Most people have group health insurance and its a non-issue.
However, those who still have private health insurance still contend with the loophole that insurance companies do not HAVE to cover the child under those policies. Its stinky. And, I think its incredibly stinky that this company lied to this family in the first place and sprung this on them after homecoming. In fact, iirc the Class B Waiver for medical conditions requires that you list what insurance coverage you have for the child, so the company caused the parents to unknowingly lie on a federal immigration form.
I don't think this family has any legal recourse for this. Its possible if the insurance agency put it in writing that the child was covered they might. But, Federal law intentionally doesn't address individual insurance policies. Someone might need to go back to coporate work to gain group health insurance and then wait the year for the pre-existing clause to pass if its possible. The only other really viable option is to apply for state insurance for the child, but most states require a 2 year residency before you can qualify for state insurance benefits.
Trust me, I understand how vital health insurance is in adopting medical needs children. But, Dh cannot pursue a career in self employment for this very reason, we have 2 highly medical needs children who require the protection of group health insurance. So, he works corporate jobs to keep our children with the health insurance they need for their medical needs.
Great info. I was about to say that I thought it was federal law that adoptees be covered but I had no idea about private insurance.
Part of our paper work required to adopt from Korea is a written letter from our insurance company that our adopted child will be covered. Was this not required for this family?
bjaneen
08-28-2008, 01:20 PM
what a crock. can they get insurance from another company just for their DD? ehealthinsurance.com is a great resource.
TestifyToLove
08-28-2008, 02:49 PM
Part of our paper work required to adopt from Korea is a written letter from our insurance company that our adopted child will be covered. Was this not required for this family?
Yes, I thought this was a requirement. We had to provide it for India when we did a medical needs adoption but not W. Africa when we adopted an older, healthy child. It appears from the OP that the insurance company initially stated the child was covered but upon homecoming rescinded that statement. I honestly don't know if it was in writing whether the family can legally hold the insurance company to it now.
As I said, Dh works corporate jobs for the very reason that we MUST have group health for the children. We have a son whose monthly treatments run $15,000 and another who is running around $8,000 at this point. Adequate health insurance is vital for them.
sourpatch_babe
08-28-2008, 03:09 PM
that is unbelievable
starstruck444
08-28-2008, 04:12 PM
I have private insurance and they can pretty much get away with anything. I even had them deny to pay for a medication my doctor prescribed because I didn't really need it!:headscratch: Apparently the insurance adjuster knows more about my medical condition than the doctor!?! It really does suck!:yuck:
