[sands]

Ugh! We are self-employed and in the process of changing health insurance to get good coverage for the kiddos when they get here.

Here is the bad news... if we wait to switch until after trip #1, they will consider all the children's medicals as pre-existings! How unfair is THAT - especially when most of those medicals are false! So, we have to change now before we accept referrals and pay the super-duper higher rates (over $500 a month!!!). Anyone come across this? It seems kooky to me and I kept fighting the insurance lady on it.

Also, can you please help me with what tests, shots, medical evals you all had done once the children were brought home? I don't know what we are in for as far as how many trips to the GP, how many trips/what kind of trips to specialists, Rxs, etc. Can someone shed some light on this for me?

I don't know if they will need EKGs, EEGs, CTs, speech therapy, developmental therpay, etc.

THANKS IN ADVANCE! You realize how little you know about children when you are forced to make decisions regarding them!

[Waiting4Skip]

I'm afraid I can't help you with the medical insurance issues.

As for shots, Skip was totally up to date on everything. We had him examined by the doctor who initially reviewed his referral medical infomration immediately after returning home with him and he was found to be in excellent health. He had a "laundry list' of medical problems according to the records he had from Russia, and none proved to be valid. We did one Ultrasound to rule out one of the Dx on his medicals, and it came back perfectly normal, including all the blood work.

We had his pediatrician examine him twice now and he is excellent health. She concurred he was up to date on his shots, and gave him a clean bill of health.

I'm sure this isn't always the case but we certainly were happy about the outcome.

Good Luck!

Judy

[waitingonVandS]

This is from "The Russian Adoption Handbook", which is a must read for us adopting from Russia. Author is John Maclean.

P. 350 "The Health Insurance Portability and Accountability Act of 1996 mandates that all employers who provide group health coverage for their employees must extend the same coverage to adopted children as they do other dependents. Coverage MAY NOT BE RESTRICTED because of pre-existing conditions and must take effect at the time of the childs placement".

Do some more research on that Act and let us know what you discover.

[Jim_in_PA]

Originally posted by waitingonVandS
This is from "The Russian Adoption Handbook", which is a must read for us adopting from Russia. Author is John Maclean.

P. 350 "The Health Insurance Portability and Accountability Act of 1996 mandates that all employers who provide group health coverage for their employees must extend the same coverage to adopted children as they do other dependents. Coverage MAY NOT BE RESTRICTED because of pre-existing conditions and must take effect at the time of the childs placement".

Do some more research on that Act and let us know what you discover.

My understanding is this act does not cover folks who are self-employed or otherwise puchased individual policies. That's why the original poster is having the issue they are...the insurance company's individual policies determine coverage.

[ahnasmom]

....but between the two kids our medical bills have to be well over $100,000. But, we have great group health insurance so they must be covered, regardless of pre-existing conditions. I believe it's required to not have the pre-existing clause when you have 50 (100?) employees within a 75 mile radius...something like that.

Anyway, both of our kids were sick, hospitalized in the PICU, had all sorts of test & then surgery, were revaccinated, etc....Alex has had tubes in his ears and was circumsized...we went to the Dr's at least once or twice a week for both kids the first month...Alex maybe the first two months...and we are not done yet...hopefully, he will be needing surgery on his eyes to correct his nystagmus early next year...but that will be after a trip to a very specialized specialist ($$$$$) to find out the 'why' of his condition...then that surgery, we pray!!

We pay about $400 a month for our policy BUT out of that $100,000+, our out of pocket maybe was $1,000....so worth it!

Ahna we knew about and were prepared for the medicals...Alex was surprise since he was labeled low risk and very healthy.

Personally, I would get it now...pay the few extra $$ now compared to getting bogged down under huge medical bills later.

[1moretime]

I have my own policy also since my employer does not offer it. I admit I was not switching as you are. When I first called my carrier, before the adoption took place, they told me that they would cover his expenses like he was a new born child. What they didn't tell me was that I only had 30 days from adoption date to add him to my policy for this to be true. I could add him after 30 days but he would have had to have been underwritten. Therefore, his probable eye surgery would not have been covered if I had let it slip through the crack. I was very anxious to have him on the policy in case something came up so I acted quickly. It wasn't until I called to check a claim and they began to give me the run around that it came out that if I hadn't been so prompt his expenses would not have been covered. They have been good so far about coverage.

I am not sure about the whole referral step. You do not legally have these children. Therefore, I can't imagine you would be able to have them underwritten. However, most policies do have a waiting period when you, the main provider, first sign up (for me I think it was 9 months). If a major illness should develop during this time the plan may decide that this family member had a pre-existing condition and will do like you said, either not cover it wor charge outrageous premiums.

Wish I could give you better info. If you stick with the insurance you do have, be sure to be prompt and give them all the pertanent (sp) info., such as copies of birth certificates and adoption certificates.

As for vaccinations. I did not want my child, who is 7, to be innoculated again for things he was immune to. So I requested titers run. A titer is where they take a blood sample and check the antibody level. His paperwork showed where he had been given immunizations for all childhood diseases but his titers told that he did not have antibodies for 2 diseases. He then only had to become current on just 2 immunizations, not all of them which is what they at first wanted to do.

It may take a little bit more time and effort but I really believe this is the better way to go than just assuming that the child's paperwork is correct or to just go ahead and give all of the immunizations all over again. Especially if your child is an infant.

Nancy

[laura-jean]

correct.

we added victoria to the policy a few days b4 she was actually adopted (guatemala, different process than russia).

i believe that they CANNOT hold any pre-existing items against you.

i am self employed, own a dr's office, was licensed as a insurance agent at a point and have pretty good knowledge of ins. although NOT an expert.

victoria was added just like a new born. technically she wasn't adopted until 8/24 but we just added her as of 8/14 to make sure there wasn't a lapse.

do be careful about being prompt about it. the thirty day thing i believe is very correct. just have the paperwork ready and start it a bit earlier than anticipated.

hope this helps.

laura jean
proverbs 22:6

[ddahl]

How can they do that when their not legally your children yet? Can you find independant group insurance? Some small business/self insured people can participate with the same in an insurance co-op. Maybe this will help. How do they know you have a trip 1? What about well baby care in your state? Will the children qualify for that? Check it out. Florida has a program for infants that is not exclusive to being on the poverty line or in a lower socio econimic bracket to qualify. (not that the cost of IA is not moving all of us toward that level-LOL)You just have to be a baby to 4 year old to qualify! Can you call the local department of children and families services? Good luck to you! Its a challenge.

[Littleruler3]

The children should or will have physicals and should be up to date on all shots before adoption is final. Unless its really necessary I would not have all that done unless your ped really recommends it, because it could red flag your insurance company!Tread lightly until you actually have your children!




Mary