The Health Reporter Is In: Jan. 25, 2017

The Health Reporter Is In: Jan. 25, 2017

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Q: I’m worried about my son losing health coverage under an ACA repeal and wonder how we should prepare for this? He’s under 26, isn’t in school and we still cover him under our health insurance because he doesn’t have benefits where he works.

A: There’s a good chance he can remain under your coverage regardless of what happens at the federal level if he meets the age requirement and isn’t married.

Illinois has it’s own dependent coverage law that allows for that, and it’s been in effect since a year before the Affordable Care Act came along. But you’ll want to take note of the additional restrictions in the state law.

One of them is that only “unmarried” adult children can stay on a parent’s coverage up to age 26, and an unmarried military veteran dependant can stay on a parent’s coverage up until age 30.
Illinois’s law is also less broad than the federal law in some other ways, too.

Under state law, health insurers and managed care plans can apply additional eligibility requirements, such as the young adult must have the same mailing address as the parents.

The federal health care law, on the other hand, prohibits health plans from denying or restricting coverage for a child under 26 based on financial dependency, residency, student status, employment or marital status.

Illinois’ law applies to all individual and group plans that offer dependant coverage, but it also has some exclusions, according to the Illinois Department of Insurance.

The state law doesn’t apply to insurers that don’t include dependent coverage, self-insured private employers, self-insured health and welfare plans and insurance policies or trusts issued in other states unless the member lives in Illinois and the health plan has a provider network in Illinois. And as of 2011, short-term travel, disability income, long-term care, accident-only or limited (such as dental or vision only) or specified disease polices are also exempt.

With so much uncertainty surrounding the ACA repeal right now in terms of when and what parts of the law might possibly be retained, the advice of Champaign County Health Care Consumers Executive Director Claudia Lennhoff to parents and young adults currently covered under parent policies is to sit tight for a bit and wait to see how things play out in upcoming months.

Nobody is likely to lose coverage under a repeal before next year, she said.

Lennhoff also strongly advised against leaving a young adult who is currently on a parent’s health plan and turning 26 this year uncovered for part of this year just because ACA repeal talks are under way.

Aging out of a parent’s coverage is one of the qualifying life events allowed for special enrollment, she said, and there would still be opportunities to sign up for a government marketplace health plan or Illinois Medicaid this year.

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