Times are changing, and more and more people find themselves in the position of having to raise, or help raise, their grandchildren. Often this is due to teenage pregnancy. But no matter the cause, it brings up several important questions regarding health care insurance for grandchildren. Most importantly, grandparents are asking whether or not their grandchildren can be covered under their health insurance plan.
There are two common assumptions regarding this question. Namely:
- If I have a teenaged daughter and she becomes pregnant, my grandchild will be covered, at least for the initial hospital stay.
- My grandchildren cannot be covered under my insurance at any time.
Both assumptions are incorrect. We encourage you to check with your insurer for specifics, as policies vary, as do state laws regarding who must be recognized as a dependant. With that said, however, here is the truth of the matter:
- Your daughter’s pregnancy and any treatment she receives will be fully covered, including neonatal treatment, as long as she is still a dependant or otherwise on your policy. Your grandchild, however, will not be covered by your insurance in most cases. You should look into one of the many available plans which cover children, preferably before the baby is born.
- If your grandchild is legally your dependant (more about that later), he or she can be covered under your health insurance just as if he were your son or daughter.
It goes without saying that you want your grandchildren to have adequate health care coverage. If your children are not in a position to provide that for them, it’s natural that you would want to step in and help. Unfortunately, unless your grandchildren are legally your dependants, there might not be much that you can do.
There are several characteristics regarding legal dependants. In most cases, all of them must be met for your grandchild to be considered your dependant. They are as follows:
- You are expecting to raise your grandchild to adulthood.
- Your grandchild is less than 22 years old (this will likely soon change to 26).
- Your grandchild is living with you full time.
- You are the main source of financial and material support for your grandchild.
- The child’s parental relationship is with you rather than with his or her natural parent.
Essentially these laws are the same as they would be if you were adopting a child or are taking care of a foster child. Of course, laws vary from state to state, and some insurance companies are more lenient in their interpretation of a dependant than others. There is no law anywhere which forbids insurance companies from offering coverage to dependant grandchildren, at any rate, so it doesn’t hurt anything to ask your human resources department if it is possible to add your grandchildren onto your policy.
One thing which should be said by way of clarification is that there is no penalty for changing circumstances. For example, if you say that it is your intention to raise your grandchild to adulthood and down the road, your son or daughter’s situation improves and they are then able to adequately care for the child, you will not be asked to repay anything for medical care your grandchild has received while he or she was under your care.
If your child is covered under your health insurance, it is likely that your grandchild will qualify for medical coverage under Medicaid until you can make more permanent arrangements, such as gaining guardianship of the baby or arranging for health insurance coverage if you haven’t done so before the baby is born. Sometimes, grandparents don’t find out about the pending birth until it’s happening (or shortly before). In these cases, you can still make arrangement for the child after he or she is born.
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