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Health Insurance

Preexisting Medical Conditions of Dependent Health Insurance

We wanted to add one additional piece of information regarding this topic, and that is regarding preexisting medical conditions.

Unlike in previous years, employer plans are no longer allowed to refuse coverage to children under age 19 because of a serious medical condition. Unfortunately, although the new law permits children to remain on their parents health plan until the age of 26, they may be refused coverage due to a preexisting medical condition if they are applying after they reach the age of 19. A ban on coverage exclusions for adults that is similar to the one for children is planned to take effect by 2014.

Fall is a time for new beginnings (not to mention warm clothes and pumpkin spice lattes!). So what better time to purchase health insurance coverage for children, especially for your children? Since Obama’s new health care plan, children under the age of 26 are allowed to remain on their parents’ plans, regardless of marital or financial status. This is good news! Here are a few helpful hints to guide you along the way.

First, be sure that the child doesn’t have a coverage offer from his or her employer. Otherwise, this option might not be an option after all. Parents wishing to enroll their child or children on their health plan are able to during a specified enrollment period that both insurers and employers are required to notify their customers of. While plans are not permitted to charge more for adult children than those under age 19, they can up the cost of family coverage. For many companies, if they can…they will! So be aware of this possibility. In addition, many employers are now more likely to have their employees verify dependents’ eligibility for coverage. A potential roadblock of eligibility is divorce, in that the child may not be financially dependent on the parent that qualifies.

Did you know…

  • As a general rule, employers are not permitted to place annual coverage limits that are less than $750,000 for health benefits considered essential, such as hospital services, drugs, emergency services and/or maternity leave and newborn care?
  • By 2014, these coverage limits will be gone?
  • By September 23rd of this year, more regulations will be put into effect for new plans either offered by employers or bought by individuals since March 23rd? These include (but are not limited to) insurers: covering the entire cost of preventive services with the highest recommendation of the U.S. Preventive Services Task Force, allowing women to see an OB-GYN sans referral and not making plan members pay higher co-payments/coinsurance for out-of-network emergency services.

Health Care and the Economy

It shouldn’t come as much of a surprise that countries with universal health care systems are faring much better in terms of economic cutbacks. And how! The National Bureau of Economic Research recently published a study that revealed that Americans have cut back on their normal medical care, such as routine checkups, significantly more than those in countries such as Britain and Germany.

According to the researchers, this alarming discovery is due in part to the fact that about 15% of Americans are currently uninsured, as opposed to other countries that have nearly complete or complete universal health care coverage.

Europeans with universal coverage often pay a few out-of-pocket costs when it comes to medical care, but it is clear that they are much better off health insurance-wise than we currently are. It is not common for people living in countries with universal health care to cut back on their routine medical care. The researchers from the study say that the cutbacks are most likely to happen to 3 groups: young people, people with low incomes and people greatly affected by the economic crisis. However, not all hope is lost, thanks to the new health care law. President Obama hopes to turn this trend around with his plan to provide coverage for more than 30 million uninsured Americans.