How to Get Health Insurance for a Child Who Has Pre-Existing Conditions
- 1). Find out what your rights are for health insurance coverage. If you are getting your insurance from your employer then go to dol.gov and look at the page describing the Health Insurance Portability and Accountability Act of 1996. This page explains in detail what limits can be applied to a new employer plan to exclude coverage for preexisting conditions.
In other words, if an employer changes benefits to a new health care plan, they might not be able to exclude your child from being covered. Other conditions that can't be seen as pre-existing clauses under this act are: conditions present in a newborn or if a child is younger than 18, is adopted or placed for adoption, and also if the child is enrolled in coverage within 30 days of the adoption, birth or placement in the home. The bad news is there can be no break of insurance longer than 63 days. - 2). Try to keep the child from losing any coverage he might already have. If you are laid off or released from your employment through which you had your insurance and your child is sick, then look into getting a COBRA. On the DOL site a page detais how a COBRA works.
COBRA is the Consolidated Omnibus Budget Reconciliation Act of 1985, which requires many employers with health plans for their employees to have an opportunity to continue their coverage under any new plans or if employment is terminated. - 3). Consider COBRA but understand the costs. If you had insurance through your employer at the time the child was initially diagnosed with the problem then you should receive a notice from your employer or the health plan letting you know you can use COBRA.
Understand that paying for a COBRA will be a hefty fee for you since the employer is no longer obligated to pay a part of your coverage, but this insurance is much better than trying to pay the cost of hospitals stays or medicine on your own. - 4). Look into getting aid for your child's insurance. In a decade where banks and business have been given government assistance there's no reason you shouldn't look into getting help for your child if possible. There is a program for children's coverage known as CHIP, which can be found on insurekidsnow.gov. The program was started in 1997 as a state and federal partnership to provide low cost insurance coverage for families with children who did not qualify for Medicaid, but who could not purchase private health insurance coverage. In 2009 the Children's Health Insurance Program Reauthorization Act provided funding to renew and expand this program. When you apply for this program, remember to read carefully all applications and paperwork just as you would any legal contract. Have all relevant data like your child's Social Security number, your pay stubs or other proof of income available. Never send original documents through the mail. Send only copies or get more documents from the source rather than sending you own unique copies (See Resources).
- 5). Get what coverage you can by checking with HMO's or other plans, such as Aetna, to see if there is not at least some coverage you can get for your child with a pre-existing condition (See Resources).
Understand that these companies will request that you release medical reports to them about your child's health. Fill out all application forms completely and honestly remembering that not reporting to the best of your knowledge might be considered an attempt to defraud.
It might be hard finding how to get insurance for your child with a pre-existing condition, but there are laws in place to help you.
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