<p>Not to mention, I suppose, just how each insurance company may interpret the law(s)?</p>
<p>My better choice of words should have been-What a mess!!!</p>
<p>Please be very careful of policies that are “$100/month” or less. Not only do these policies have high deductibles (several thousand dollars) but your lifetime benefits are capped at very low amounts. For example, the company may only pay out $30000 for a year and $100000 for a lifetime. Some hospitals may require a deposit of several thousand dollars from you before they will consider treating you for something like cancer even if you have this insurance.</p>
<p>I’m not saying that these policies don’t have their place in the health insurance landscape, but you should thoroughly understand the cap before you buy.</p>
<p>There will be government regulations promulgated by the Dept. of Health which will limit the amount of creative “interpreting” that can be done. </p>
<p>Yes, of course insurers will try to figure out away around requirements they don’t like - but that happens with any legislation. If there are abuses, they will be resolved through administrative procedures, litigation, or follow up legislation.</p>
<p>It actually is not as much of a wholesale change as you might imagine, from the insurance company’s perspective. Many states already have similar regulations in place and the major companies, that do business in multiple states, have figured out what to do. Most insurance is employer-based, and those group policies are already subject to all sorts of restrictions that protect the insured. The main impact of the law might simply be to give the unemployed, underemployed, retired, & self-employed the same bargaining power that those who work for major companies already have. My son works for a large employer – when his live-in girlfriend got pregnant last fall, he was able to add her to his policy immediately as a domestic partner – and the policy provides terrific maternity benefits. So they didn’t face any of those pre-existing condition issues that can make it hard for already-pregnant women to get appropriate care throughout the pregnancy. </p>
<p>So its not going to be all that hard for insurance companies to make the shift. </p>
<p>Personally, I kind of suspect that Anthem Blue Cross announced that big rate hike in my date because they wanted to push the bill through, no matter what their official position is. What company can complain about a law that requires more customers to buy their product? Anthem is one of the main company’s that markets to individuals – I am sure they are way ahead of the curve on this. They probably wanted to push through rate hikes ahead of the anticipated law-- but I’m sure they also figured that they’d try to get away with a much bigger hike than they needed.</p>
<p>Thumper1 – That was my concern as well, but I’ve been assured by the health care liaison in a senator’s office that it will pre-empt ERISA, meaning this regulation will apply to all corporations, including those that self insure – which is most of the larger corporations.</p>
<p>Also…the provision mandates coverage through age 26, not up to age 25.</p>
<p>Notre Dame AL,</p>
<p>HHS is tasked with implementing the nuts and bolts regulations that will apply to all employers and their insurance companies. There is no room for interpretation. :)</p>
<p>Duck Mom,</p>
<p>Yes, you can go back and add your daughter after the six-month waiting period, which will end on Sept. 23, 2010. I think we’re likely to do COBRA between June and Sept, and then re-instate our son.</p>
<p>OK, anyone want to bet on our specific situation?
Our son is a FT grad student, turning 24 in June 2010. Still our dependent.
He was covered until Dec 31 2009 on my SELF INSURED employer policy.
We declined COBRA (>$550/month) and bought him a high deductible individual policy.</p>
<p>Any bets that we will be able to add him BACK onto my employer plan in Sept?</p>
<p>Can someone tell me if I am interpreting what the bill says as correct? Our student graduates on May 16. We are all covered under spouse’s self-insured plan and pay the monthly family premium (rates remain the same whether it is 2, 4 or etc. dependants). According to the policy coverage right now, our student will no longer be covered after midnight the day of graduation (not thru the end of the month, even tho the premium is for the entire month!). Fortunately, student will begin a new job exactly one month later (June 18). Which means student (according to current policy coverage) will have no insurance or we could elect to pay Cobra for the month at a very costly rate (in addition to paying the monthly premium for rest of family). Can someone tell me if the new bill (continuing coverage up to age 26 if dependant but not necessarily in school) will cover our situation for the month without having to pay Cobra for a month in addition to our regular premium? Or does this new bill not take effect until later? I would like to be prepared to intelligently discuss with our insurance company this issue should they inform us that nothing has changed even with the passage of new health care bill. Thanks for your replies!</p>
<p>The new bill won’t help you because it doesn’t take effect until September. HOWEVER, I think you should wait about 3 weeks and then talk to someone at your insurance company, because I anticipate that companies will develop their own protocols as to what to do in the interim. There is nothing to prevent your company from voluntarily changing its rules to comply with the new law ahead of time – its a low risk group, and the net value of the good will, retained customers, extra premiums, and saved paperwork might make it worthwhile for some companies to step up to the plate and make the change for that particular group immediately. (Even though it costs YOU the same whether or not your son is covered, there are other policy holders who might drop their plans if their sole remaining dependent ages out of it, and the insurance company is going to have to weigh the potential cost in lost policies and the employee time/paperwork involved in dropping people in May & June and then reinstating them in September. If they won’t let change the terms of their policy out of the goodness of their heart (ha,ha) - it might occur to some companies that there is money to be made if they sell families like yours a short-term rider to carry over from May to September.)</p>
<p>If not – there are various insurers on the open market that will sell short-term policies that can cover your son during the gap period between the time he graduates until the insurance at the new job kicks in. This is probably less expensive than COBRA – see [Short</a> Term Health Insurance - Temporary Health Insurance Coverage](<a href=“http://www.ehealthinsurance.com/short-term-health-insurance]Short”>Short Term Health Insurance | eHealth) – also check to see if there are any group policies available via your son’s alumni association.</p>
<p>This is not really news. The first provisions of the health care bill do not come into effect until 6 months after the bill is signed, that was pretty clear from the beginning. Once the provisions are effective, you should be able to add your dependent child who is under 26 back to the healthcare plan you have, and at the rate they were on before (ie they will still be covered as children, not some special rate for adults). You should check with your insurance company to see what their protocol for this will be, but just because they graduate in 2010 and are kicked off the plan does not mean they will not be able to join back on and be covered once the provisions of the law go into effect. </p>
<p>In the meantime, in some states kids are ALREADY covered until they’re 26 (I was under my parents plans) and for the less lucky states there is COBRA as a possibility, or else you can look for a “young invincibles” plans with high deductibles. Also many colleges and universities offer health insurance at a reasonable rate through the school (international students are often required to purchase these insurance plans). </p>
<p>Otherwise, you have to wait six months and then just get your kid back on the plan.</p>
<p>my plan health plan at work extends coverage for a child beyond normal 23 years if the child is disabled. My son was removed from plan when he was 23 years as he was not disabled at that time. He is on COBRA now. He will be just under 26 on September 23 of this year (his birthday is on Oct 12, 2010 when he turns 26) – and he is disabled now – would he be able to continue to remain on my plan after he is 26, if I re-enroll him on September 23 into the plan.</p>
<p>Another question – can the employer have a two tier system for health care payments (one for people under 23 – which is reduced rare and the other one for people from 23 to 26 years old – in asking them to pay the full premium).</p>
<p>baran1913-
Probably varies by plan.
My self insured employer plan allows my disabled now 20 yr old D to remain on my plan forever if needed. I need t pay the ‘family’ rate instead of the ‘husband/wife’ rate but a bargain anyway. So, my plan is her primary, and Medicaid is her secondary.</p>
<p>sen schumer on meet the press a few minutes ago said his daughter who graduates from law school in june will be covered!! ? wont have her own insurance until job in september… so does the 26 yo provision kick in now or later??</p>
<p>The requirement for insurance companies to provide coverage to adult children through age 26 becomes effective in September. </p>
<p>However (as I’ve posted elsewhere) – nothing in the law prevents insurance companies from making that change sooner. Additionally, some insurance companies have grace periods before the insurance expires in any case. </p>
<p>I honestly think that many insurers are going to implement that particular change sooner – or else offer families some sort of rider they can purchase in the interim. I might be wrong, but I think it would be in the financial interest of the insurers to do so. This age group is very low risk. The availability of such coverage will encourage some families to remain on more expensive family plans, as opposed to dropping down to a less expensive plan if the graduate is their last child; there is a lot of paperwork entailed in dropping and then re-adding subscribers. (Personally, if I ran an insurance company – I’d go with the short-term rider or “bridge” idea – send a letter out to subscribers telling them that the new law will be effective in late Sept., but if they want they can purchase a 90 day rider to their policy to keep junior on, for say, $200. Of course I’d have to consult with my in-house counsel as to the legality of the plan … but it sure looks to me like a nice way for an insurance company to rake in a little bit of extra money).</p>
<p>Thanks for your replies calmom–honestly, I think it remains to be seen as to whether insurance companies might do what you are suggesting^^. I don’t think ours will–and at this rate, according to computer records, student is covered under tthe plan until Sept 1 (in other words, paperwork has been satisfied until then-would have to prove at that time that student is enrolled in school on Sept 1 for student to continue on plan-as it stands right now). Student is not paid up until Sept 1 as we make monthly premium payments. What is disgusting is the fact that supposedly student’s coverage ends at midnight the day student graduates–(May 16) not at the end of the month, even tho the premium is for the month. Yes, we can obtain Cobra. Right now, we think we are going to do nothing–student graduates May 16, will begin new coverage with new job on June 18. Will go on to regular Dr. visits on May 20 (can’t get home until then)-checkup, dentist, etc. We will see if insurance company is smart enough to pick up the fact that student graduated on May 16, yet has Dr. visit on May 20. If they will not cover this or any other medical event during this period, we will then elect Cobra, as we can go back 60 days with it. </p>
<p>I originally asked this question because of the questions that seem to continue to keep coming up about the Age 26 portion of the bill. It appears from other posters that WHEN the coverage actually begins is still somewhat up in the air (see post 33). We will continue to watch and wait at this point for more clarification–esp from (hopefully) our insurance company! Again, What a mess!!!</p>
<p>why am i not surprised schumer may not even know what the bill says LOL!! when my oldest finished college we bought basically a hospital policy through Assurant Insurance(state farm agent actually got the policy for us). It would not cover dr visits etc but would cover any hospitalization… it was for 6 months at a time and was only about 100.00 for the full 6 months. that might be an option for some of you…most can pay dr visit but a hospital bill could be horrendous. They allowed us to keep renewing for about 3 cycles, until he got a job that had insurance.</p>
<p>I think the problem with the hospital-only insurance is that if the kid is injured or becomes ill in a way that requires chronic outpatient care, you could have some huge problems. The emphasis these days is to do as much outside the hospital as possible – so I would think you would want to read the terms of those policies very carefully. Though the addition of the high-risk pools and elimination of pre-existing conditions in 2014 makes that option somewhat safer than it used to be.</p>
<p>
That’s very close to what my d’s insurance company told me. (I called up to ask them questions without identifying myself – so I need to verify this by carefully reading the policy). My d has an individual policy, but the problem is that she was allowed to maintain Calif. coverage while in NY by providing proof of enrollment in college. Once she is out of college, and still in NY – that won’t work any more. Calif. insurance is significantly cheaper than NY coverage – huge difference. </p>
<p>The Calif. insurer told me that they won’t pay NY claims <em>after 60 days</em> – but they aren’t going to do anything until they start seeing bills from NY. In the past, d. would get routine care from her college health clinic (no bill to insurance), and visit the doc here in Calif. when home visiting for her annual check-up or other minor ailments. So as long as my d. doesn’t need a doctor in NY – the Calif. insurer will go ahead accepting the premiums. </p>
<p>I don’t think this is safe as a long term plan – I don’t want to be in a fight with the insurance company over “fraud” or some violation of insurance company terms about reporting a change of address while my d’s lying in some hospital in NY (though if my d. was really, really ill… seems to me that the first thing I’d want to do would be to bring her home). But it does give us some breathing room for May & June. D. is probably going to be living on somebody’s couch anyway – we can’t give an insurance company a new address until she has one. NY apartments aren’t exactly cheap, either… and I’m not contributing a dime to d’s rent. (If she needs a place to stay, I’ve got a room here she can use, and I’m happy to pay for her one-way ticket to get here). </p>
<p>Sometimes you can get true catastrophic coverage very cheap-- d’s alumni association seems to offer it. I’m not talking about the high deductible policies – I’m talking about a policy that only kicks in when expenses are over $50K or $75K or so - that’s why they are so cheap. No preventive care, no deductibles — they are just meant as umbrella coverage after the primary insurance runs out.</p>
<p>This is what Senator Schumer said on Meet the Press: </p>
<p>SEN. SCHUMER: And then there’s a little hidden one, just one final one. If you’re up to 26 years old you can stay on your parents’ health coverage. My daughter is graduating from law school. We told her the day after she graduates she’s on her own. She has a job in September, but she was fretting what does she do for the four months? Does she buy health insurance for $1200 a month? Well, she called me up at midnight after the bill passed and said, “Dad, I’m covered.” </p>
<p>This left me very confused but further research (including info provided here) has convinced me he was wrong. I hope someone calls his daughter and tells her to get out the checkbook ;).</p>
<p>
</p>
<p>One would hope. I know for MY employer…the open enrollment period is over June 15 for coverage beginning September 1. (our insurance is paid through end of August). The EMPLOYERS will be the ones to take these graduates OFF the policies…and put them back on…and collect Cobra or whatever. To be honest…it will be a PITA especially for small employers. Simply put…if my kid isn’t covered until Sept 23 (she finishes school end of August), I would need some kind of coverage until Sept 23…and my EMPLOYER would need to figure out how to prorrate my insurance costs…Sept 1-23 would be 2 person…after that family-3. A PITA.</p>