[StampnWendy]

Hey everyone! I hope someone can help me We have been presented with a situation and I don't know the answer to this! I can't get in touch with my facilitator this early

We have been presented with the opportunity to adopt twins that were already born and in NICU at 32 weeks. When would our medical insurance take over? When we sign the agency paperwork or when they are released to us. I'm pretty sure that the babies are being covered now under Medicaid or Medicare? I don't think the birthmom had insurance. We have some real weird medical insurance that covers normal medical expenses, but then have a huge co-pay for anything over. I'm assuming that the cost for NICU is huge!! I just don't want to say this situation is for us (the cost is around $36,000) and then have to pay an additional $15,000 is co-pays for the hospital)!!!

Thanks for any help!!!

[kakuehl]

I wish I had an answer for you... I don't, I wanted to let you know, someone saw your post.

One thing you could do is call your insurance and find out when they would pick up coverage.

[sadiegirl]

Wendy,

How about calling your insurance agy? B/c, from what I've gathered in the past, everyone has different insurance. Some co's will pay and some won't. It all depends on who you have and what they cover.

Good luck.

[BrandyHagz]

I am pretty sure that what is going to matter here is the TPR and also when the agency releases the children to you.

Has mom already TPR'd?

If so, then you'd likely take custody as soon as you accept the placement...meaning, you would need to cover any medical expenses from that point on.

Maybe the agency has thought of this - the expense and everything involved...maybe they have asked the the mom not to TPR until the children will be released, meaning the coverage they have now will continue until that time.

Medicaid ends at TPR - so that's what you need to find out.

[StampnWendy]

Thanks for your responses!!

I called my insurance co. this morning and of course, they are closed for the weekend I'm pretty sure TPR is today...but the birthmother hasen't made a decision as to the aparents yet. Will she still be able to sign the TPR without deciding on the aparents?

I was able to get in touch with my facilitator and she said she would find out about when our insurance would kick-in ...I'm guessing that it's all a matter for a signature on a piece of paper?

I really think this situation is good for us, but then again, the fees are high enough (and don't incude NICU). I'm also assuming that the babies will be in NICU for a few weeks since they were born at 32 weeks?

Thanks again for any help - I've been a lurker on here for a while and haven't had to post...but this is just driving me crazy!!

[christophersmommy]

what state are you in? reason I ask is that certain states require by law ins companies to pick up adopted children (adopted from the hospital) retroactive from birth.

Here is the NYS statute. You should really contact an attorney as the ins companies will generally fight you on this.

Any family coverage shall provide that coverage of newborn infants, including newly born infants adopted by the insured or subscriber if such insured or subscriber takes physical custody of the infant upon such infant's release from the hospital and files a petition pursuant to section one hundred fifteen-c of the domestic relations law [Temporary guardianship by adoptive parent] within thirty days of birth; and provided further that no notice of revocation to the adoption has been filed pursuant to section one hundred fifteen-b of the domestic relations law [ Special provisions relating to consents in private-placement adoptions] and consent to the adoption has not been revoked, shall be effective from the moment of birth for injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities including premature birth, except that in cases of adoption, coverage of the initial hospital stay shall not be required where a natural parent has insurance coverage available for the infant's care. In the case of individual coverage the insurer must also permit the person to whom the policy is issued to elect such coverage of newborn infants from the moment of birth. If notification and/or payment of an additional premium or contribution is required to make coverage effective for a newborn infant, the coverage may provide that such notice and/or payment be made within no less than thirty days of the day of birth to make coverage effective from the moment of birth. This election shall not be required in the case of student insurance.

[StampnWendy]

I am located in North Carolina, but the adoption would take place in NV. When I spoke with the facilitator, I was assuming that Medicaid was covering at least the birth and up to when we signed. She said no, that it may have been a freebe from the hospital - I have never heard of that????

[BrandyHagz]

Its not retroactive to birth - its retroactive to placement.

Because you have 30 days to add the child after placement, they are required by law to cover the child from placement.

Many children are NOT placed at a young age...say, a 10 year old placed at age 10...insurance would not be retroactive to birth, it would be retroactive to placement.

Please make sure you talk to your agency, they will be familiar with the FEDERAL law that requires group carriers with a certain number of employees to cover adopted children from the day of placement and NOT finalization, which can be more than a year after placement, in some cases.

[momtutu]

While our son was in the NICU the agency retained custody of him. His mother signed shortly after birth, however his hospital stay was 14 weeks long. We did not sign to take placement until the day he was released from the hospital. Medicaid covered his hospital bills completely. The agency gave us permission to be with him as often as we could. The hospital gave us bracelets to wear as well. We are in Florida.
Lisa

[shortlittlemama]

Our situation sounds very similar to momtutu's. Our little man was a 30 weeker; Medicaid covered until he was released to us- which was his release from hospital at 37 weeks. Insurance picked up from there (but would have covered earlier if necessary). Of course, then he had to have a very expensive surgery 2 weeks after we made it home, which involved deductibles, copay, etc.

[joskids]

I know that even if there were some medicals that you needed to pay, the hospitals are very good about making arrangements to pay monthly. IF that helps. But if she has medicaid, I'd think it's covered.

[2manyks]

our baby was covered from birth by our insurance. bmom was on medicaid. her expenses were covered. our insurance did become retroactive, covered our baby from birth. i am sure every insurance co is different. you should check w/ your ins company. dont they have an after hours or emergency #? i am sure it would be very important for you to know this before accepting the situation and if bmom doesnt want to sign TPR's until you accept you are inbetween a rock and a hard place.

please update us when you find out.

[StampnWendy]

Thanks everyone for your help! This board is so amazing!

We did find out that we would have to pay a deductible of $8,000 and then our insurance would pay 70% from the time we sign the paperwork. If I figure $100,000 for the 3 or so weeks they would be in NICU (and I'm thinking that would be a low number), that would be a bill for us of at least $30,000!!

Anyway, we found out today that the bmom dedcided to parent herself, so at this point, it doesn't matter - oh well

Thanks again for everyone's help!!!