Wednesday, August 18, 2010

Redefining "Child"

Jane and Mike are insured under an individual medical plan, and their 20 year old son Tom is covered under a similar, separate one. Yesterday, they emailed me to ask when and how they could add Tom to their own plan, so that they have just one, family deductible. Under ObamaCare©, "children" encompasses young'uns up to age 26 (or 28, here in the Buckeye State. Back to that shortly).

Since coverage for "children" continues to be a moving target, I could answer based only on the process as it stands today. At his age 20, this coverage is NOT guaranteed issue, so he'd have to complete a new application. Assuming he's approved, he would then be added to Jane and Mike's HSA plan, and Bob's your uncle.

I can certainly see the value of this process from Jane and Mike's perspective: instead of two sets of deductibles (one for Jane and Mike, and a separate one for Tom), there's just the one family deductible. It's likely that Tom's rate as a dependent will be lower than his separate plan.

All good so far, right?

From Jane and Mike's (and Tom's) point of view, of course it is.

But then it gets sticky. Under ObamaCare© rules, Tom can stay on the folks' policy until he's 26. But in one of those Stupid Government Tricks, Ohio has decreed that "the insurer must offer to cover the unmarried child until the child's 28th birthday" (assuming he or she is otherwise still eligible).

Now, discerning readers may ask "what boots it? What possible difference does it make to you, or the carrier?" And that's a valid question.

The problem is that dependent coverage is underwritten and priced for, well, dependents, not adult children. We're already seeing the effects of the new rules on pricing and availability; this little "trick" serves to exacerbate them.

[Hat Tip: FoIB Kelly W and FoIB Fred W]
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