Adoptive parents can be reassured that under federal and state law, their health insurance plan must treat an adoptive child the same as a “natural” or biological child and must provide coverage at the time the adoptive child is legally placed in their custody prior to finalization of the adoption.
The Omnibus Budget Reconciliation Act of 1993 (OBRA’93), Public Law 103-66, amended the Employee Retirement Income Security Act of 1974 (ERISA). The amended law requires that any group health plan which provides coverage for dependent children must provide benefits to a child placed for adoption under the same terms and conditions as apply to a child who is the biological child of a plan participant. OBRA’93 specifically eliminated any requirement that the adoption be finalized in court before there is coverage.
Under ERISA, the adoptive child is covered by the adoptive parents’ health plan at the time the adoptive child is placed with the adoptive parents. ERISA defines the term “placement” or “being placed” for adoption, in connection with any placement for adoption of a child with any person, as “the assumption and retention by such person of a legal obligation for total or partial support of such child in anticipation of adoption of such child.”
Typically, in an independent adoption, the adoptive child is legally placed with the adoptive parents when the birth mother (and birth father if he also is placing the child for adoption) signs the adoption agreement. This document usually is signed at the hospital upon discharge and legally places the adoptive child with the adoptive parents. In most circumstances, this also is the time when the adoptive parents take physical custody of the child.
In addition, the new law also prohibits insurance plans from excluding an adopted child from coverage solely on the basis of a preexisting condition if the adoptive parents request enrollment within 30 days of placement. It is best practice to make sure that upon discharge, hospital administration has the adoptive parent’s insurance policy information. Therefore, it is important that adoptive parents request enrollment of their adopted child within 30 days of placement. Also, under HIPAA, a child adopted by an individual during the period of COBRA coverage is considered a qualified beneficiary and will be allowed to be enrolled in the plan immediately.
Review the Health Benefits Coverage under Federal Law here.
Review the Newborn and Adopted Children Coverage Model Act here.
Enroll in or change your health coverage here.
Adoption Choices of Arizona hopes to always provide you the most current and accurate information regarding the adoption process, laws, and processes. Please contact us to discuss your adoption options as an Adoptive Family or Birth Parents.
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