Health Insurance Question
SS currently has health ins. through the state we live in, which the court required since it was cheaper for DH to pay for state ins than his ins through his work. I’ve never been on any kind of health care, etc. through the state so I’m really unsure how everything works and how you qualify for these things. When the state originally ordered SS’s ins to be through the state BM was not working – living on her own with her two kids – and going to school part time, so she obviously qualified for a lot of assistance. My question is…she is getting married in September, she’s done with school and has a part time job and her fiancé works full time (for the time being). Some people have told me, once she gets married she will no longer be covered by the state and therefore SS won’t be able to be on the state either. Does anyone know if that is true?
I have tried researching this. DH has tried calling his case worker (since the ins company won’t tell him anything because it’s in her name not his) and his case worker never calls him back. DH has been asking BM to look into it for months but she’s always “too busy”.
The pressure is on now because I start a new job in July and the benefits are fantastic so we will be switching to my ins. and I will only have a small window to add SS. I don’t think I can add him later, if he does get kicked off the state ins. I would have to wait until open enrollment again and I don’t want him being uncovered for any amount of time.
Does anyone know anything about this? Where I should look to find the answers? Or are people leading me astray and everything will be fine.
what does your agreement say
what does your agreement say in terms of how the child gets covered?
if BM has access to family coverage she may have just as much responsibility to cover the child as does your husband.
given that your husband has access to insurance and he's been allowed the choice to put the kid on state insurance, then i dont think that BM now having insurance woudl be any different.
if he does get kicked off the state, that's a qualifying event, and your husband or BM could then pick him up provided they sign him up within the window of time which is typically 30 days from the loss of coverage.
From my understanding neither
From my understanding neither BM or her fiancé have jobs that provide health ins. but it is a requirement in our state to have ins no matter what. What confuses me is the way she gets insurance. She got pregnant last fall and was originally going to get married at the courthouse right away and then have the official wedding after the baby was born. Then I talked to her one day and she told me they decided not to do that because she found out that if she was married the state would no longer cover the pregnancy and birth? Which lead me to believe the particular insurance she is on, is income based. Now granted I don’t know exactly how SS’s works and neither does she (which is very annoying – and even though DH pays 100% of his ins. cost, they will not give him access to any information because it’s in her name and she refuses to call them and grant him access – which is a completely different argument). I also know she has to fill out paperwork regularly and if she doesn’t SS loses his ins, which happens A LOT, pretty much anytime we have to take him to the doctors.
So what I was told, was when she gets married she will have two incomes and no longer financially qualify for state coverage. But again, I have no clue if that affects SS as well.
You can check when you sign
You can check when you sign up for your new insurance, but at least at my company you can add people outside of open enrollment if there's a "Change of Circumstances" - and losing existing insurance qualifies. So you *might* be able to add the SS's if they lose their state medical.
Then again, at my work I actually can't add the SDs to my insurance (ever) because they do not reside primarily with us (meaning >51%) and they are not related to me. You may find that you're actually not allowed to add the kids to your insurance regardless of their current status.
Now, I can tell you that while our BM is NOT covered by state medical, my SDs most certainly can be. Obviously that can vary based on the state, but just because BM can't be on state medical does not necessarily mean that her kids can't. My best advice there is to call the insurance company again and ask "hypothetically". That is, don't ask about a specific policy, ask them "If my exW and kids are on state medical, which I pay for, and she gets remarried, what's the deal with who can stay on insurance? I want to be sure my kids are still covered and find other insurance if they won't be." The policy is the policy is the policy - they should be able to tell you in general what their policy is.
From my understanding neither
From my understanding neither BM or her fiancé have jobs that provide health ins. but it is a requirement in our state to have ins no matter what. What confuses me is the way she gets insurance. She got pregnant last fall and was originally going to get married at the courthouse right away and then have the official wedding after the baby was born. Then I talked to her one day and she told me they decided not to do that because she found out that if she was married the state would no longer cover the pregnancy and birth? Which lead me to believe the particular insurance she is on, is income based. Now granted I don’t know exactly how SS’s works and neither does she (which is very annoying – and even though DH pays 100% of his ins. cost, they will not give him access to any information because it’s in her name and she refuses to call them and grant him access – which is a completely different argument). I also know she has to fill out paperwork regularly and if she doesn’t SS loses his ins, which happens A LOT, pretty much anytime we have to take him to the doctors.
So what I was told, was when she gets married she will have two incomes and no longer financially qualify for state coverage. But again, I have no clue if that affects SS as well.
im still trying to figure out
im still trying to figure out how this kid even qualifies for state insurance in the first place.
but it sounds like the coverage is spotty anyway, thanks to BM.
whiel it will cost him some money, id consider just having your husband pick the kid up on his plan. That way you have full access to everythign and its probably better than the state plan.
I completely agree!!! I
I completely agree!!! I don't understand it at all and BM is such a chronic liar it's hard to know whats true and whats not. She once told us that having SS and her other child on state coverage, allows her to get food stamps and if we removed SS from that, she wouldn't be able to feed him...
Same situation with BM. She
Same situation with BM. She remarried last year and she says that the skids no longer qualify for state aid now that she is married and has a dual income.
Not sure how much I can help you because BM lies all the time, so we really don't know if this is true or not. I would think this is correct though. I carry insurance for DH and myself so if she wants skids added we told her our open enrollment is in December so that's when we can add the kids. State aid is actually MUCH better than my insurance. BM is aware she would have to help us pay the deductible and out of network and right now she doesn't pay anything out of pocket.
Sorry I can't be of more help, but I would be sure you have your ducks in a row for skids insurance (if you choose to cover them) because this does sound right.
It's so frustrating!! It
It's so frustrating!! It might just be best to add him, since I can. Even if he ends up having double, just to know he's covered would be wonderful.
Usually, if there is a
Usually, if there is a significant change, you can add/remove from your insurance policy. That would include no longer being eligible for alternate coverage.
BM insured the oldest SS
BM insured the oldest SS while DH insured the youngest SS through employer insurance. Then when the youngest SS went into the Navy, all DH had to do was call Cigna and it was a qualifying event and he didn't have to insure him anymore. Not sure how it all works now with Obamacare though. And I do know that my BIL who is unemployed while his wife is in prison, his youngest son who is 16 is insured through the state. He was insured through the state as well before BIL lost his job.
Unless you have 51% custody,
Unless you have 51% custody, you may not be able to insure him anyway.
Normally, if a qualified
Normally, if a qualified dependent (your SS) loses coverage through another insurance provider, you don't have to wait until open enrollment to add that dependent. It's called a qualified status change I believe.