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encyclopedia of adoption

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insurance

The primary insurance concern of most adoptive parents is health insurance for the newly adopted child. State laws varied greatly in the past when an adopted child was covered by health insurance, and many companies disallowed certain claims made for an adopted child because they evolved from preexisting conditions.

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The Health Insurance Portability and Accountability Act, passed in 1996, stipulated by federal law that children adopted with "preexisting" conditions could not be denied insurance coverage. Of course, this refers to cases in which families have health insurance coverage, which is probably the vast majority of adoptive parents and it also refers to conditions that are included in their health plan. The point at which the child is covered may still vary from state to state, however. Some children are covered from the point of placement in the home.

In a few states, children are covered before arrival in the home; for example, the medical expenses of a newborn after birth and still in the hospital are covered in some states. Generally, the cost of childbirth is not covered. Adopting parents should check on what their state law mandates. Particular provisions of each state law should be checked by adopting parents to determine whether they comply with various requirements, such as deadlines for enrollment in insurance plans or filing claims.

Some adopted children are covered by medicaid, which adoptive parents may be able to use indefinitely or at least until they are able to use their own private insurance.

Because of the difficulty in obtaining health insurance coverage, many children with special needs are covered under Medicaid, a federally-funded health insurance program; however, many physicians refuse to accept Medicaid. (See also EMPLOYMENT BENEFITS.)

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