What are my rights under the Health Insurance Portability and Accountability Act ?

Question

My 19 year old daughter, my only dependent, has been covered by my group health insurance policy all her life. She got pregnant last year and was unmarried. She carried the baby until the sixth month and lost it due to chromosomal abnormalities. That pregnancy was covered by my group insurance. She is now pregnant for a second time but has just informed me that she got married in February 2006. When I contacted my benefits office, I was told that I had missed the deadline for requesting a conversion policy for temporary coverage for my daughter and that there were no exceptions. This seems so harsh since she now has no coverage for this pregnancy. I am willing to pay the increased premiums back to the date of her marriage. I have continued to pay my family premiums and am not asking for a reimbursement. Do I have any rights under the federal law that requires a employer to allow a dependant to convert to an individual policy? Jan

Answer 1

HIPAA does not require that employers and insurers cover dependents at all, nor does HIPAA prevent a group plan from imposing an age restriction on dependents. So I don't see a HIPAA violation here. However, there may be several alternatives available to her:

1) Call your state's Children's Health Insurance Program (this is separate from Medicaid/Medical Assistance). All states administer this federally-funded program. Pregnant women are eligible to enroll.

2) Is your daughter working? She may be able to obtain insurance through her employer. Her pre-existing condition of pregnancy is protected under HIPAA. Note, though, that she cannot enroll outside of the open enrollment period.

3) Once your daughter's insurance termination is processed, the insurer must send her a form known as an "Evidence of Creditable Coverage" form. She can use this as proof of prior group coverage when purchasing her own individual policy. HOWEVER, she must do this within 63 days of the date her group coverage terminated. You don't state when that was, so I can't tell you whether she's still eligible for this.

4) Now that she's no longer on your group plan, she can enroll in the insurance offered through her husband's employment, provided that he's already enrolled. State laws differ regarding this issue, so you may want to call her state's insurance commissioner's office.

5) If she's financially eligible, she can enroll in Medical Assistance. Because she's married, it's not likely this will be available to her, but you can try.

I hope this helps. Send me a message through YA if you have any questions.

Answer 2

She no longer is a dependent since she is married. If her husband has insurance she can automatically go onto his plan (without preexisting condition) since they were married. There is nothing you can do since she is now married. If her husband doesn't have insurance the only way she can convert to an individual policy only if she was covered under another plan when she discovered she was pregnant. So if she discovered she was pregnant while insured and then got married then she may be able to convert to an individual policy, if she provides a COCC letter from her previous insurance company to show she has previous coverage. Hope I helped.

Answer 3

You mean you didn't even know she got married. I really don't believe you should be supporting her when she is married; and she didn't even invite you to the wedding.
If she is old enough to be married, she is old enough to take care of herself.
Let her find out the hard way so she grows up; otherwise you are just babying her and she will never grow up.
How can you expect an insurance company to cover her when she is married. They will expect her husband to.
They cover dependents, up to 25, if they are going to school, and usually only 18 or 19, when they are living with you and not going to
college. They are never going to cover her if she isn't living with you.

Answer 4

it is not a contravention of HIPAA for pharmacy techs to by twist of destiny hand somebody the incorrect prescription if those people have the comparable final call. they might desire to look on the prescription first and verify the address or some thing earlier handing it to the shopper, whether it is not a contravention of federal regulation in the event that they do no longer. it truly is sloppy, confident, yet it somewhat is approximately it. in case you do no longer consider me you're loose to record a criticism with the workplace of Civil Rights with the dep. of wellbeing and Human centers. the drugstore would face sanctions, yet you're no longer likely to get something out of it.

Answer 5

HIPPA is only in place regarding information. Healthcare professionals are required to inform you on how they disclose your information (i.e. what your insurance company gets on a claim and how they address you in the office) It has no bearing on coverage.