Re: adoption and medical record requests

Eek.

I know nuffink and I hope people who do will show up and be able to give you some answers.

But that's kinda eek, just wanted to drop in to say so/ commiserate. Hope that all works out as smoothly as possible.

I dunno. But they accepted him then, no? And doesn't that previous condition thing usually mean just a six month wait?

Insurance fool here, don't listen to me.

I am semi shook by their wanting 5 yrs med recs. Huh?

Thanks soz. I can use a hand holder as much as I can an advisor. I'm a little freaked out and Mr. B is absolutely livid.

Re: adoption and medical record requests


It can vary somewhat depending on the laws of your state. In many states the insurance company calls the shots and they can cancel your insurance or refuse to pay for treatment in the future if they determine they did not have all the information required. You might want to call you State Attorney General for the rules on what insurance companies can and can't do in your state.

Yeah -- they talked about "an exclusion period" in the letter.

I can deal with that. He has asthma that is triggered by allergies. It is hardly a problem at all.

I'm just worried that they'll cancel us or something. Panic, I guess.

You might also want to inquire about attorneys dealing specifically re this kind of stuff, not that I know there are such, or that those that are, are reputable.


This sounds rather skulky. Is it a major company?

Thinking - and with no clue of said condition - maybe Mo hasn't records prior to you, or if so, much in them. What would that mean to their apparent effort to boot him?

With my daughter (the Type 1 diabetic) the insurance company refused to cover anything related to her diabeties for two years when I changed policies.

I don't think many of them will even try to cancel. They just exclude for whatever time period is establishe din your policy and state.

Yes it is a major company.

And yes, I'm going to make a little note of the attorney general's phone number. Thanks for that idea, GreenWitch.

I'm going to kind of see how it plays out before I start kicking up a big fuss.

That whole "You're sick? Sorry." stuff is nuts, fishin'.

The exclusion period isn't really a big problem for us.

I suppose I'm more worried about not being able to provide the information that they're asking for and whether that alone will enable them to cancel.

I really don't want to drag his bio-parents into this. In the letter I stated that he was born with the name "ABC" and I believe he was insured under the state's insurance program.

Here is what the letter says:

The name and address of every physician, dentist, urgent care center, hospital or other health care provider that you visited during the five (5) years prior to the effective date of your coverage with X and, for each of those providers:

A completed authorization to release protected health information.

(emphasis theirs)
(possible typos mine)

I had blue cross when I worked at ucla, stopped working there and got on another insurance, and a few years later, as a self employed person, at bc again. They excluded me in the latter episode for six months for asthma claims (I've never had an asthma claim) and no problemo.

I guess I'm not clear, will be quiet for a bit.

I guess I'm not clear on what I'm not being clear on!

The question isn't the asthma -- the question is that I can't provide 5 years worth of health history. I'm about 9 months short.

I'm short because Mo was living with his bio-parents. I don't know the name and address' of his doctors and all the bold faced everys that the letter wants to know.

I'm worried that these incomplete records will affect his insurance as the letter says it could.

boomer, call the social worker you've dealt with while Mo was still
your foster child. They might help you in obtaining health records and
any other information you might need.

That's what I did, when some of the immunization records were missing
when I got little Jane. Social services didn't have the records but they
put me in touch with the pediatrician who immunized her.

Yes, I got that, but didn't know what to say...

Mo was never officially a foster child so he isn't in the system at all. The only contact we had with a social worker was when they did the home study.

I did try to notify social services that he was here after he had been here for about six months just because I thought someone should know where he was. They said that unless I wanted them to come pick him up and put him in foster care that there was nothing they could do.

Crazy crazy crazy.

I'll send my letter and see what happens. If worse comes to worse I'll call his mOther and try to get some info but I have a feeling that won't really lead anywhere.

He wasn't diagnosed with asthma until about a year and a half ago so maybe that will make a difference. Maybe they can just extend his exclusion period.

I hate these damn insurance companies.

My post was in between, ignore. I'm just being vocal.

Oh, and I've opinions on insurance companies. I remember us not eating much in my teens to keep up with the insurance bills.

Boomer, you have my sisters' email addy, right? She's a social worker, dunno if a generic social worker would help........

Boomer
Boomer, I don't know the State in which you live, but this info may help:

[Code of Federal Regulations]
[Title 45, Volume 1]
[Revised as of October 1, 2004]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR146.111]

[Page 600-603]

TITLE 45--PUBLIC WELFARE

SUBTITLE A--DEPARTMENT OF HEALTH
AND HUMAN SERVICES

PART 146_REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET--Table of Contents

Subpart B_Requirements Relating to Access and Renewability of Coverage,
and Limitations on Preexisting Condition Exclusion Periods

Sec. 146.111 Limitations on preexisting condition exclusion periods.

(2) Adopted children. Subject to paragraph (b)(3) of this section, a
group health plan, and a health insurance issuer offering group health
insurance coverage, may not impose any preexisting condition exclusion
in the case of a child who is adopted or placed for adoption before
attaining 18 years of age and who, as of the last day of the 30-day
period beginning on the date of the adoption or placement for adoption,
is covered under creditable coverage. This rule does not apply to
coverage before the date of such adoption or placement for adoption.
--------------------------------------------------------

AND:

http://www.adopting.org/adoptions/health-insurance-for-adopted-children.html
---------------------------------------------------------

http://www.idfpr.com/DOI/HealthInsurance/HIPAA_preexisting_cond.asp
-----------------------------------------------------

I hope something here will help you.

BBB

Thanks little k - I'll keep your sister in mind as a resource!

Wow BBB - that looks really promising! Thanks for finding that. I'm off to read the links right now....

boomer - I'd suggest making a call to the State Insurance Ombudsman/person/whatever. Insurers tend to be VERY responsive to calls from those offices.

The ombudsman's office may only be able to turn you in the right direction at the beginning, but if there are ongoing snafus it'll help to have someone already interested in how this resolves.

ahhhhh in Oregon, it appears to be called the Consumer Advocate.

http://www.cbs.state.or.us/ins/publications/consumer/3235.pdf

http://www.cbs.state.or.us/ins/