by mundine » Fri Jul 24, 2009 03:28 am
I turned 25 in January and was taken off my mom's health insurance policy through BCBS of Texas. I was appalled when I went for my next doctor visit and found out I had to pay $94.00 for the visit now and that my two prescriptions were now going to cost 189.00 a month. I am a divorced mother of 3. Where can I get insurance for myself. The kids are covered under Medicaid. I work part time at a convenience store (minimum wage) and get $200.00 a month child support. This doesn't leave enough for me to pay for my monthly doctor visit and the prescriptions. Plans I have checked into costs even more than that just for the premiums. Is there any low cost plans in Texas, or even Bastrop county?
Posted: Thu Aug 13, 2009 02:23 am Post Subject:
This is actually a pretty simple question...if ya know the answer! All questions, if you know the answers, are simple!
Without knowing in what state you reside, I can still offer you a pretty educated opinion.
Every state has laws and rules that deal with coverage for children on any medical expense plan. Most states use the following set of rules, with some MINOR variations between them. In order to insure a child as a dependent on a group or individual health policy:
1. The child cannot be married. The OPs child met this requirement as of the divorce of her FORMERLY married daughter.
2. The child must be claimed on the parent's tax returns as a qualified dependent. This metric was met.
3. Normally, most states require that in order for the coverage to continue past the "limiting age" that the child be enrolled as a full-time student. Not all states require this, but most do.
Also keep in mind that state rules and statutes only require the insurer to meet MINIMUM requirements; they can ALWAYS be more beneficial to the client than the laws allow, they cannot be more restrictive than the law allows. Specifically- most states say the following:
* All policies that cover families (both group and individual) are required to cover dependent, unmarried children until at least age 19. Not through age 19, TO age 19.
* That age must be extended to age 23 if the child is enrolled as a full-time student, but still dependent on their parents and unmarried.
* If the child is "incapable of self-support" due to congenital or other anomalies and will be dependent upon their parents forever, there is no limiting age.
Again, the insurer can always be more beneficial than the law allows, but not more restrictive. It sounds as if your carrier didn't care much about the full-time student nor the age 23 rule; this is perfectly legal as their rules are MORE beneficial than the law requires.
As far as coverage is concerned, there are normally state options available for those who are having insurability problems and state options for those who cannot afford the premium costs. Children (under 18years of age) always have more options than adults, and state Medicaid is commonly used to take care of kids.
If you'll tell me what state you live in, I could provide you more specific info!
InsTeacher 8)
Posted: Thu Aug 13, 2009 05:45 pm Post Subject:
We live in Texas. The main question has gotten lost in all of these posts. My daughter is 25, has a low paying part time job and needs health insurance. I was just trying to figure out what her options are and how to find something in her price range.
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