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What if my child is not listed as a
beneficiary under either parent's health insurance?
Sometimes even if a parent has group insurance coverage
through an employer, family members are not covered because the
premiums would cost too much. You will want to talk about this with the
team social worker, who should know more about financial resources that
may offer help. If possible, the insured parent should talk with their
employer (or their employee benefits person at work) about how to
enroll their child. Some plans have annual or semi-annual "open
enrollment" provisions that permit coverage despite current medical
problems. If the plan has a waiting period for adding dependents with
pre-existing conditions, such as a child with a cancer diagnosis,
families still often find it worthwhile to enroll the child. Cancer
treatment can go on for long time and cost a lot. Insurance issues can
be very complex and many families need help not only in finding
answers, but also in even knowing the right questions to ask.
What can we do when work does not offer us
group medical insurance?
Families that do not have medical insurance through an
employer can explore several options:
- Look into whether you and your family can get group
insurance through an organization in which you have, or can arrange,
membership. This may be a group like an alumni association, a fraternal
organization, a farmers' cooperative group, a labor union, a
professional organization, or a group such as the American Automobile
Association (AAA).
- Find out whether your state has a Comprehensive Health
Insurance Plan or a high-risk pool through which you may purchase
insurance for your child. A high-risk pool is a state-created,
non-profit association that offers health insurance coverage to people
with pre-existing illnesses. Federal money was made available in 2002
to help states fund these plans. Benefits, premiums, and waiting
periods will vary, but most states with such pools have rules that
control what can be offered. Your state department of insurance or
insurance commission can give you more information. See the section
"State coverage and health insurance options for the hard-to-insure."
- Decide if one parent should look for a job with a large
company that offers medical insurance or managed care with open
enrollment provisions. Open enrollment guarantees coverage despite
current or past medical history or status. Rules about waiting periods
vary from state to state.
- Look into buying individual insurance to cover your child.
Although this is costly, rates have become a bit more competitive with
private insurance companies who see this as a business opportunity.
- Some states have "guaranteed issue" individual plans that
are available regardless of past health problems. Also, some states
have state-subsidized health insurance options for low-income
residents.
- Find out if there are health maintenance organizations
(HMOs) or health care service plans in your community. You can
sometimes get very good coverage through these plans. Many offer a
period of open enrollment each year during which applicants are
accepted regardless of past health problems.
- If you and your child have been covered under your
employer-sponsored plan for at least one day you should be able to keep
your medical insurance through COBRA. Your employer should be able to
tell you, in writing, about your COBRA option. For more information,
please see the previous section "COBRA
(Consolidated Omnibus Budget and Reconciliation Act of 1986)".
- Look into your child's eligibility for Medicare, which
covers people who are permanently disabled and have been getting Social
Security (SSI) for 2 years.
- See if your child is eligible for state or local benefits,
such as Medicaid if you are in a low-income bracket or are unemployed.
If you are employed, don't leave your job until you have found out if
you can convert your group insurance to an individual plan for your
family. Some group plans have a clause that allows people to convert,
but premiums may be much higher. These individual plans usually must be
applied for within 30 days of leaving a job. (This is different from
COBRA, which allows you to stay with the group insurance but only for a
limited time.)
In looking at insurance options, find out about differences in
coverage. Ask about choice of doctors, protection against
cancellations, and increases in premiums. Find out what the plan really
covers, especially in the event of catastrophic illness (a serious
illness, like cancer, that can add up bills quickly). What are the
deductibles and co-payments? (Sometimes higher deductibles go along
with better or more complete coverage.)
If you feel an insurance company has treated you unfairly,
contact your state insurance commission for more information. See the "Additional
resources" section to find your state insurance department.
Back to Children Diagnosed with Cancer:
Financial and Insurance Issues
Last Medical Review: 04/01/2009
Last Revised: 04/01/2009
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