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tmtm | Does group insurance have to cover a dependent with pre-existing conditions? |
Here's the background. I live in Seattle, WA. I am engaged and my fiance has a 2 year old daughter who had a heart transplant when she was 5 weeks old. They live in Canada and are canadian citizens. If we were to live in Seattle once we are married, would a group insurance policy through my employer have to cover her daughter since she will be a dependent? That is the biggest problem we face with the moving here. |
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Good♥Gyrl
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It all depends on the group contract. The issue is also whether or not the group contract covers citizens, regardless of guardianship. Are you going to be a legal guardian of the 2 year old once they move here? If not, you might not be able to add her, anyway. Is the mom alive and supporting the daughter? Was there anything in the divorce decree that stipulated who was responsible for health care? Since she is not your legal child, unless you're adopting her -you first need to get over that hurdle. Plus, just because you marry her dad and she moves here, she will not be a natural citizen due to that alone. |
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nurse ratchet
 |
Depends on lots of things. She could get portability since she had other coverage prior to the group. It could be a large group (over 50 employees) and they don't have pre-existing limitations, and it could be not covered for 12 months. I suggest asking the HR person where you work. If they don't know, they can contact the insurance company and ask them. I highly suggest they get the name and extension of the person they talk to at the company, too. |
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Phil O' Brien
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No it would not have to cover your new daughter's pre-existing condition |
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davidsirknight
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If the insurance company had an "open" enrollment period most preexisting conditions are waved unless specifically mentioned in the group policy. However, in this case you must already be covered and the step daughter will not be picked up for the pre-existing condition...it has been a long time since I looked at these types of policy's. It is best to find the Human service personnel at your work and directly ask them. I think that in a few cases it might depend on how long has past and if there were further complications, with the age of the child it is best to be sure and find out from the master policy. All underwriters and insurances are not totally equal it is not likely but sometimes they miss something and it could change everything. What have you got to lose to talk to human resources? |
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emariagethai
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it really depends on each policy |
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Nina
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The big question is do they have insurance coverage now? If she had insurance through all her medical treatments and is just converting to your plan then it will be covered because there would be proof that she had insurance through her medical treatment. The reason for preexisting condition is so people don't buy insurance just when they get sick. If she doesn't have insurance then it will be a preexisting condition and she can have coverage but it won't cover any ailments associated with her heart problems. |
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mbrcatz
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Depends on the group. With a large employer, they most likely would. Even if they didn't, you should contact the WAshington CHIP program, which can provide insurance coverage through the state for children with issues like that.
I'm assuming there's no health insurance in Canada? |
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