QUESTION
Is there a law that would require the insurance company to allow my son with special needs for coverage?
Asked on Mar 18th, 2014 on Family Law - California
More details to this question:
I have a special needs son who is 25 years old, I need to know that if I retire early (60 yrs. Old, so I don’t qualify for Medicare.) Once I retire will I be able to have my son covered under any medical insurance policy I end up with or will they exclude him due to his disability. His intellectual disability is so limited he is classified as a person in need of ICF (Intermediate Care Facility) meaning her requires 24 by 7 support. He is currently covered under my employers plan now but if I retire early I am not sure if a new provider will allow him as a dependent under their policy. Is there a law that would require the insurance company to allow him the coverage? I know he can default to Medicaid but the coverage is below par and finding a primary care doctor is almost impossible. Can you help? Thank you.
6 ANSWERS
Business Planning Attorney serving Livonia, MI
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Frederick & Frederick Attorneys at Law
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I do not think anyone completely understands the health care regime we now find ourselves in. Things will gradually sort themselves out. My understanding is that it is no longer possible to exclude someone from coverage, due to a pre-existing condition. Whether that means he would qualify for a plan as good as yours or not is impossible to say. I would discuss your concerns with your provider and see if they can give you additional insight.
Answered on Mar 19th, 2014 at 3:38 AM
Probate Attorney serving Newport, OR
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Minor, Bandonis & Haggerty P.C.
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You might pose this to Disability Rights Oregon. It's possible that the Affordable Care Act (if it survives the next year or two) might help you.
Answered on Mar 19th, 2014 at 3:38 AM
Commercial Attorney serving Chicago, IL
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Ashcraft & Ashcraft, Ltd.
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The Affordable Care Act (Obamacare) should cover your situation. Your son cannot be denied coverage due to a preexisting condition. He can only be covered under your policy as a dependent until age 26. You should inquire about policies for your son through the exchanges set up under the Act.
Answered on Mar 19th, 2014 at 3:37 AM
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Call Covered California and ask them this question.
Answered on Mar 19th, 2014 at 3:37 AM
Commercial & Bankruptcy Law Attorney serving Powell, OH
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Ronald K. Nims
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Under the current law, health care insurance companies can't reject her because of his pre-existing medical conditions. However, medical insurance doesn't cover nursing homes. ?You should look into a trust to provide for your son after your death. If he's in a nursing home on Medicaid, they will take his inheritance.
Answered on Mar 19th, 2014 at 3:37 AM
Trusts Attorney serving Sacramento, CA
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Law Office of Victor Waid
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You need to consult with a specialist in insurance coverage, rather than a lawyer.
Answered on Mar 19th, 2014 at 3:36 AM