Thursday, September 23, 2010

What About My Child Who Was Cured of Cancer?

For several days, radio and televisions broadcasts have said it: beginning September 23, 2010, under the Affordable Care Act applying to grandfathered group health plans, health insurance enrollees who are younger than 19 years of age cannot be excluded from benefits or denied coverage because a condition was present before the date coverage became effective (or denied).

The hype sounds good, but what if your 19-26 year old child was treated for heart disease, lung disease, cancer, leukemia, Hodgkin Disease, Wilson's Disease or any other serious condition and the insurance company says "no" to someone age 19-26 with a pre-existing condition under the grandfathered plan?  (A grandfathered plan was one existing on March 23, 2010 and a new plan is one established after that date.) While minors must be covered, not until 2014 will the  pre-existing prohibition for adult children be eliminated.

Sophisticated advisers stress the importance of keeping a close eye on employers' grandfathered plans.  When new insurance is written or major revisions to existing plans take place,  "grandfathered" plans may become new plans and work under a whole new set of more consumer- protective rules.  Pay attention.

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