by shirazrose » Wed Jan 09, 2008 03:20 am
He was in an automobile accident two years ago and has had many surgeries since. He recently missed this last semester ofhigh school due to a surgery. We were told the insurance can drop him if he does not re enroll soon....Please advise
Posted: Wed Jan 09, 2008 10:34 pm Post Subject:
He was in an automobile accident two years ago and has had many surgeries since. He recently missed this last semester ofhigh school due to a surgery. We were told the insurance can drop him if he does not re enroll soon....Please advise
Here's the deal. Indiana, like most states, has rules and laws that govern how long a dependent may remain insured on a group policy through their parent's group health insurance plan.
That is my assumption on what the OP queried. Indiana, like most other states, requires that a group health insurance plan or policy cover dependent children of the insured employee until that child reaches age 19. If the child is still dependent upon the support of the parent after age 19 as a full-time enrolled college student, the state rules mandate that the child be covered under the group plan normally until age 23, if still enrolled full-time and still dependent.
Special rules apply for continuation of coverage under the group plan for certain disabilities and persons with cognitive or other difficulties, such as for those considered to be incapable of sustaining emplloyment due to developmental or physical handicaps. Persons under this rule set can be covered past age 23 if circumstances meet state rules...
Typically, the insurer, through the state rules, has the ability to require proof of the above situation(s) within 31 days of the terminating event (such as the child reaching age 19) in order to continue the coverage past the limiting age. For disabilities, proof can again be asked for within 2 years of the originating approval, and then annually thereafter.
I would suggest going to the Indiana insurance home page, checking the laws and doing some research. There is more to this than can be taken care of through a post, and I encourage you to speak with the carrier that provides coverage on your child. Let them know of the situation and normally the carrier will provide you with the info necessary to continue coverage.
Please let us know if there is anything else that we may be able to help on.
InsTeacher 8)
Posted: Thu Jan 10, 2008 01:14 am Post Subject:
Thanks for all your help I already had called Aetna and they said they have never heard of the 89 day stipulation, furthermore he is covered under this plan regardless of his school status. I also called the Attorney General's Insurance line and they said that it was up to the carrier not the state to decide. I did try and contact my son's dad to find out exactly where he got his information, however he appears to be unavailable.
If anyone has other names of websites that I can research that would be greatly appreciated!!!
Posted: Thu Jan 10, 2008 11:20 am Post Subject:
the state rules mandate
So it IS state laws that govern this then? good to know...and thanks a bunch!here is your states DOI web site (home page) http://www.in.gov/idoi/
here is the 'health insurance page'' http://www.in.gov/idoi/health/
i didn't go thru any of it but it looks like one of the better sites with tons of information...
i'm quite surprised that aetna said they hadn't heard of this! Becareful that they aren't sending their requests to your son's father rather than yourself, and you missing or not getting this request, and thus (as far as aetna is concerned) not responding to their request, then losing his coverage! :shock:
Posted: Thu Jan 10, 2008 02:47 pm Post Subject:
Thanks a lot, those were great sites. I did review them, as well as call an agent. She asured me that there is no STATE law that governs any 89 day provision. I suppose state law overrides any other "rule", that may be imposed. Thanks again for all your help. If you hear of anything pertaining to this mysterious 89 day rule, please let me know.
Thanks again
Posted: Fri Jan 11, 2008 11:12 am Post Subject:
Again, there may not be an 89 day rule, but I'm just sure there is a ''full time student status'' rule....you will have to ask aetna their ''definition'' of that term....(be sure and check with dad as i said re: requests he may have gotten from aenta to provide this proof...i'm worried about your boy (and for you) losing that coverage!)
Posted: Tue Jan 15, 2008 06:07 am Post Subject:
have u checked whether his insurance is still valid or not????
if yes then go ahead
Add your comment