I’m adopting a child who has health problems. Will I run into issues when adding them to my current health insurance plan?

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Asked April 23, 2012

1 Answer


The Health Insurance Portability and Accountability Act of 1996, HIPAA, prevents health insurance companies from denying coverage to adoptive children because of preexisting health conditions, among other things. What this means is that if you are currently a member of a group health insurance plan when you adopt the child, then the child will automatically be approved for coverage. There are a few regulations and restrictions that you must take into consideration, but in most cases you will have nothing to worry about in this respect.

The first thing you need to know is that the adopted child needs to be added to your health plan as soon as possible. The way the law is worded, you may only have 30 days to add your adoptive child to the policy before your right to do so is void. Failure to add the child within the designated time frame, and that pod differs according to your state of residence and the insurance company you deal with, could mean that you have to pay for the child's health care out of your own pocket. If the child is hospitalized at the time of adoption, it is vital that you begin the process of adding her right away.

Another situation that could be important is whether the child has a condition which is excluded for all members of the health insurance plan. If the plan excludes all members from that type of coverage, your adopted child will not be an exception. Read your policy carefully and make sure that your new child qualifies for coverage. As long as the plan covers other members for the same conditions, your adopted child will be eligible for coverage as well, but the plan will not provide coverage beyond what is available to all of its members.

Answered April 23, 2012 by Anonymous

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