When Does an Adopted Child Qualify for Health Insurance?

When Does an Adopted Child Qualify for Health Insurance?

This is obviously an important question. If you take an orphaned child into your home, even if they are perfectly healthy, you will want to have them covered under your health insurance plan as soon as possible.

Health insurance coverage is governed by rules of private contract. As such, your contract with your insurance provider will govern when and how your newly adopted child becomes eligible for coverage. That contract is usually articulated in the benefit booklet.

In our experience, there are two types of coverage: coverage that qualifies the child as a dependent as soon as the child is “placed for adoption,” and coverage that qualifies the child as a dependent when you obtain some type of legal custody or final adoption for the child.

The first category is preferable. Many times, a child will be placed into the care of the adoptive family months before a custody or final adoption decree can be obtained. By way of example, if a birth mother consents to the adoption in the hospital after delivery, the date she consents can be considered the date she placed the child for adoption. This is the case even though it may be weeks before the adoptive family files any court documents, and months before they get any kind of order from the court.

Many times, the insurance customer representative you speak with about coverage doesn’t understand their own benefits booklet. Usually there is an easy solution: A carefully worded letter, on our letterhead, to the insurance carrier explaining why the child qualifies as a dependent. 99% of the time, this shores up any misunderstandings.

For questions regarding your adoption process, feel free to reach out to us today.