First, let me start this post by saying that I am not writing this to be a negative Nancy, but rather for it to be used as an eye opener for how our health insurance company has treated the Tater as our adoptive son.
When the Tater was born, he was initially covered under Joy's (J's new blog nickname) health care. Because he went directly into the NICU verses coming home first, his stay at the hospital was covered through her health care. Let me say that for this, we are soooo thankful. I would hate to see a bill for a 6 week NICU stay.
When he came home 6 weeks after his birth, he continued to be covered by Joy's health care plan. We had spoken with them on the phone and we were told that he would not be dropped until we had him on our insurance, but at an appointment in June, we found out that he had been dropped at the end of May without our knowledge and we were now 100% responsible for his bills.
This wouldn't be a big deal, right? Well, here's the catch. Our health insurance company would not recognize him as our son until they had certain documents. This is understandable, to some extent, but at the same time, those documents that they wanted were not yet available. They wanted his social, but we could not get his social until we had his birth certificate. We could not get his birth certificate until we finalized our adoption.
We finalized Tater's adoption on August 12th and within a few weeks of that awesome day, we received his birth certificate in the mail. I had this piece of paper in my hands that stated that I gave birth to him on March 19 (which is a whole different topic). In all legal aspects, he was our son on August 12th, but that wasn't good enough for the insurance company.
We called them on August 12th, and they stated that once we had his social, we could send it all in and Tater's insurance would be post dated to the date of our adoption finalization. This was great news. This would mean that we could go ahead and do things like go to the eye doctor and while we would pay for the appointment, we would be refunded the money or the money would be credited to our account when the insurance officially went through.
Well, that would be a great thing, but things changed. When some of the health care laws passed in Washington, they made it so that we could not go back and post date our account, meaning all of the eye appointments/doctor's appointments that we thought were going to be covered, were now again 100% our responsibility. Let's just say that our first two eye appointments for the Tater cost us $1,000.00. Yes, you read that right. $1,000.00!!!!!
The Tater was not fully recognized as our son on our policy until December 8th, almost 9 months after he was born. 9 months!!!!! I find that a little ridiculous, especially when legally, he was officially my forever son on August 12th.
I know that our situation is somewhat unique due to the Tater spending time in the NICU before coming home, but to me, shouldn't it be easier? Shouldn't the insurance companies treat adopted children the same as biological children?
Just something to think about.
Friday, February 18, 2011
Subscribe to:
Post Comments (Atom)



3 comments:
From what I've heard through our agency and my mom (she works for the IRS) is that you can get an Adoption Number (works like a social) for taxes and health care purposes. I have also heard that insurance companies are required by law to cover adopted children the moment they come home with the adoptive parents. Just my understanding. I hope you can get it straightened out. I'll definitely be calling our insurance company to find out the process when we eventually bring home a baby.
I understand making you wait until August 12th but not recognizing him until December 8th is a load of poop. And they should pay you the $1,000.
Amazing...August 12th was a day of joy for you and a day of sorrow for me (don't feel bad...I'm just rambling). It's amazing how two different people can view a date so differently.
I just ran across your blog and thought I'd share what I know. Once your child is legally placed for adoption, your health insurance company must provide coverage for your child. The law is in the Omnibus Budget Reconciliation Act of 1993, Title 1V, Subtitle D-Group Health Plans, Section 4301, Standards for Group Health Plan Coverage.
"COVERAGE EFFECTIVE UPON PLACEMENT FOR ADOPTION- In any case in which a group health plan provides coverage for dependent children of participants or beneficiaries, such plan shall provide benefits to dependent children placed with participants or beneficiaries for adoption under the same terms and conditions as apply in the case of dependent children who are natural children of participants or beneficiaries under the plan, irrespective of whether the adoption has become final."
Our agency gave us a document to prove placement and we had no problem getting insurance coverage. What a nightmare for you! I hope you can figure it out.
Post a Comment