On March 23, President Obama signed the Patient Protection & Affordable Care Act into law. It contains various health care provisions -- some already in place and others that take effect over a four-year period.
One ruling, with wide applications relates to adult children. Children now can be included in their parent's health plan until they reach age 26. This applies to those young adults who previously had been on their parent's plan but were dropped.
Prior to the new law, many employer-provided plans would not cover a child unless he or she was claimed as a dependent. Some plans even required that the child live at home with the parents.
Naturally, there are all kinds of exceptions and stipulations. You absolutely must check with your insurance provider for details pertaining to your specific plan and its coverage. Here, however, are the key points:
- Coverage does not always take affect immediately. Plans don't have to extend this "adult child" coverage until they start a "new" plan year. That's typically January 1. However, some of the larger insurers started coverage as of March 23.
- Coverage doesn't just kick in. Parents must add their child to their plan when they enroll in next year's plan.
- If a child becomes eligible after the enrollment period ends, then by law the parent must be given an extra 30 days in which to enroll their child.
- If an adult child is offered health insurance at work, in some instances, he or she may be excluded from the parent's plan.
- Although married children and financially independent children are eligible for the new coverage, their spouses and children are not.
- Adult children cannot be charged higher premiums than other dependents.
- The new coverage does not apply to dental or vision needs.
- The rules about pre-existing conditions in adult children are tricky. The new law generally prohibits insurers from denying coverage for those under age 19 who have pre-existing conditions. However, the law does not apply to those whose coverage is with private insurers - in other words, those whose parents do not have a plan at work. This is one of those "you must ask" situations.
Bottom line: Check with your employer, insurer or insurance agent for specific details and to obtain the necessary forms to fill out. Do so immediately so you won't miss the open enrollment period.
For Further Information
You will find details about the new law and young adult coverage in general on the website of the Washington, DC-based nonprofit: http://www.gettingcovered.org/.
For a summary of the law as well as continual updates, check with the Henry J. Kaiser Family Foundation at: http://www.kff.org/. The home page has news pertaining to all aspects of health care and insurance.
- Nancy Dunnan
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