Insurance question

Discussion in 'Substance Abuse' started by christianmom, Dec 26, 2014.

  1. christianmom

    christianmom Member

    Is there any law that says you are responsible for your adult children's medical expenses if they are on your insurance?
  2. pasajes4

    pasajes4 Well-Known Member

    I have the same question.
  3. christianmom

    christianmom Member

    My son has been having ankle pain as a result of a sprained ankle a few months ago. He thinks he might need an MRI but won't go to the clinic (because apparently it looks like he wants to go to his druggie friends house and do drugs) instead of me taking him to the clinic. We won't have to pay anything because we already met our out of pocket maximum this year. I told him if he waits until next year, he will be the one responsible for the bill. (He has no job right now). I'm thinking maybe we will be the ones responsible. He will be 21 in a few days. Since children can be on our insurance until age 26, surely parents are not expected to be responsible for adult children's medical bills. I sure hope this is not the case, especially since he is making stupid decisions right now.
  4. dstc_99

    dstc_99 Well-Known Member

    I don't know the law on it but yes. Check into it ASAP. I know a man who just got done paying for his daughters second child's birth. The only way he can get her off his insurance is to drop the policy and then get a new one. Totally insane in my humble opinion but I called and verified it and the info was accurate.
  5. Signorina

    Signorina Guest

    That may be governed by state. That said - I do not believe so unless your adult "child" is considered your legal dependent beyond being a dependent for insurance. I know for certain that even if an over 18 is on your insurance - you will not received any access to his medical records - including bills - unless you have his medical POA.

    I wouldn't put it past a medical provider making you believe that they can hold you responsible. AFAIK - unless you signed an assignment of billing responsibility for the provider - you are not.

    FWIW - when both of my 18+ sons had their wisdom teeth removed, the oral surgeon required that we sign an "assignment of billing responsibility" before he would book the surgery.
  6. christianmom

    christianmom Member

    dstc_99 who did you call?
    Signorina - boy, your son sounds like mine, "couch surfs while pretends to live at home". He will be forced to make a choice in the next few weeks about a place to live. My question for you is, who can I call to ask about this - a lawyer? He did sign the HIPAA form for me to be able to discuss his medical information when I took him to the clinic for his ankle (but I think this is required each time he has medical care).
  7. Signorina

    Signorina Guest

    I would think that your state would have the information available. Also, I would send a note to any current provider stating that you are not responsible for any charges or debts for your adult child - just in case you have aprior assignemnt of responsibility on file.
  8. dstc_99

    dstc_99 Well-Known Member

    I spoke to our HR department. From what I was told as long as they are on your insurance then you are responsible for the bills. They can't be kicked off your insurance either up until age 26. Essentially it has to do with Obamacare. The mandate that all people have insurance makes it nearly impossible to remove someone unless they have their own insurance as back up. Even then it can be difficult. They don't want people dumped onto the welfare/Medicaid systems just because it is cheaper than paying for insurance.

    Of course this all applied to Federal Insurance since I work for the military. My suggestion is to talk to your HR and your insurance provider.
  9. Lil

    Lil Well-Known Member

    That really sounds odd...When I re-enroll every year, during open enrollment, I can change dependents. I can drop my son if I choose. I don't choose...but I'm sure I can. I work for state government. Are you 100% sure you can't drop them? I can't imagine it's lawful to force a person to carry someone on insurance when they are an adult and capable of getting their own, even if it's thru the ACA.
  10. dstc_99

    dstc_99 Well-Known Member

    I thought it was odd too. It supposedly a new thing. They literally told the employee he had to drop insurance for a month then re-enroll without this daughter.

    I think it is total crap. Hopefully it is complete crap and doesn't apply. I was furious on his behalf so I called our head of HR and confirmed it. To me it is sick to expect a person to cover their kids for all those extra years.

    I really hope I am wrong and or it doesn't apply to everyone.
  11. Lil

    Lil Well-Known Member

    That's really shocking, because there is no way to drop insurance for a month then re-enroll when open enrollment is 30 days. So basically, there's no way at all to drop the kid.
  12. christianmom

    christianmom Member

    Thank you everyone. I'm going to definitely call our insurance and/or a lawyer. Our out of pocket is $10,000 and I think we had to pay around $9,000 this year (had some extra in HRA or something like that). So technically if my son used his maximum a year, we could be liable for $50,000 (5 more years x $10,000 a year). This is insane, if this is true. It seems like it makes adults into children, also.
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I found this on the internet. I'd explore the "you have to keep them on until 26" further. I always felt it was an option parents had. That is, at least, how I understood it.

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    Last updated: Jun. 13, 2014
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  14. Signorina

    Signorina Guest

    Dtsc- that may be a provision of your policy - especially if you are employed in a contract or union type of negotiated worker environment. I am guessing that dependents are covered at no additional cost to the employee. It's most definitely not the law- just a provision of the contract your employer has with the insurance provider. Rates are dependent upon the percent of employees covered. Since younger healthy people are more likely to waive coverage, it can skew the participation to older or sicker workers who have higher medical bills. Requiring workers and dependents to have coverage balances the inurer's risk pool and lowers the rates.

    It's also very common in Union negotiated insurance - our school Union required 100% with- no deductible coverage of employees and dependents, so married couples who both worked in the district had double 100% coverage for themselves and their dependents which was really overkill- they didn't need twice the coverage at 100%!
  15. Nancy

    Nancy Well-Known Member Staff Member

    We dropped our difficult child from our insurance three years ago when she got employee covereage. Of course she only had the job a few months so when she lost that job she was without insurance. We refused to put her back on our insurance and she was able to get free health coverage through our public hospital because her income was so low. When the ACA became effective we purchased a policy on the exchange, saved $750 a month for the two of us, and did not put difficult child on ours. She went without insurance for several months but fortunately was picked up by her new employers plan. I will NOT put her back on our policy if she loses that. Our deductible is $6500 per person and I will not pay her medical bills, she is 23 and an adult. If she loses insurance she will have to apply for medicaid.

    I know that may sound mean but we learned when she was in rehab that since she was on our insurance nothing was paid and if she was on her own or had no insurance she would have been eligible for financial help. So we ended up paying 25,000 out of pocket for her rehab.
    Last edited: Dec 27, 2014
  16. christianmom

    christianmom Member

    Thank you everyone. The information has been helpful. He IS on our insurance. My question is, are responsible for what the insurance does not pay. I haven't made my phone calls yet.
  17. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I'm guessing that if he is on your insurance you are responsible. But that is just a guess.
  18. Lil

    Lil Well-Known Member

    Well, my son's medical bills come in his name though he is on my insurance. I do pay them...but I haven't checked to see if I have to do so.
  19. Signorina

    Signorina Guest

    Once your child has reached the age of independence in your state (18 in most, 21 in a few) - you are no longer responsible for the bills they incur in their name. I would GUESS that most of us signed agreements to pay on their behalf (while they were still minors) at the Pediatrician & dentist office, etc. You may need to actually revoke those.
  20. KTMom91

    KTMom91 Well-Known Member

    Miss KT is still on our insurance and we haven't received any bills for her doctor/ER visits. We paid them when she was still in college, but now that she's working, she's responsible for what she incurs.