Trying to keep difficult child 1 on our insurance

Discussion in 'General Parenting' started by SunnyFlorida, Jan 21, 2005.

  1. SunnyFlorida

    SunnyFlorida Active Member

    Hey there Blue!

    difficult child 1 ages out of federal insurance in April. Any ideas on how to keep him on? I did call the ins company and they said get this certain form from husband's work.

    He's never been hospitalized (over 24hrs), never Baker Acted. He has been in IOP x2 and is on a mood stabilizer and an antipsychotic.

    He's not been working and don't know if he possesses the capability.
  2. OTE

    OTE Active Member

    Have you looked at the plan documents? Don't they have a website explaining who qualifies for the plan?

    Read the other posts here about Medicaid and local places he may be able to get health care.

    Don't forget to look at the rules re his new baby- if he is enrolled in a plan does he have to provide medication insur for the baby too? This is a family court issue when she goes to court for child support. He'll be required to provide 50% support and 50% of medication bills. Typically a parent in a medication plan is obligated to enroll the child in that plan so I'd check that angle out before you make any moves on this.
  3. bigblueagain

    bigblueagain New Member

    I can only reiterate what OTE said. IF there was not a new baby in the picture, I would say you could most likely try to have him labelled disabled by your treating physician. BUT if he has the wherewithal to have a child, they may not agree to it. IT would take alot of background info from the treating physician. I don't think getting your difficult child insuance would necessarily mean the baby had to be added to your plan. That is usually only done when grandparents have permanent guardianship or custody. SO I would get the form as suggested by the company and at least start there. May also want to give the attending physician heads up that you may need his help with obtaining private coverage. Was your difficult child previously under a Medicaid plan? And is he aging out from it, and could he be eligible for SSI disability? That is certainly another route to look at. BLUE
  4. SunnyFlorida

    SunnyFlorida Active Member

    will post again once I read what is being asked for by current agency.

    difficult child is covered until age 22 under husband's plan. They do allow those older than 22 if they are disabled. We have not done the SSI route yet but are getting prepared to do that.

    Baby will be covered under girlfriend's work plan or medicaid.

    It is unknown what difficult child will be held responsible for as far as baby is concerned.
  5. OTE

    OTE Active Member

    As you may know, SSI gives him Medicaid in most states. When there's another insurance the Medicaid becomes the secondary insurer. But it will take a long time to get the SSI approval so I wouldn't plan on it right now.

    Just a question... did your difficult child agree to apply for SSI? Has he accepted the disabled designation? He's certainly not going to get approved unless he's willing to tell the truth about his issues over and over to various SS people. He'll have to admit to his work history and his part in his inability to hold a job. This is where many people fail to get SSI, particularly BiPolar (BP) people with grandiose thinking. And as he's over 18 you have no right to his medical records and cannot apply for him. I'll also tell you that there are some ss people, and some ss judges who hear these cases who have no sympathy for a sub abuser- they refuse to see it as an illness- they think it's willful behavior and will not approve such SSI apps. So you have to focus the app on mental illness, not sub abuse. They also may not approve an app if the person is not taking the prescribed medications. Again, the view is that they willfully refuse to take medication which could enable them to work. So an SSI app can be an uphill battle with a difficult child who was in a mainstream school, has a high IQ, lives independently, etc.