Primary and Secondary Health Insurance Coverage

Our family has had a difficult start to the year 2007! As some may know we are the Adoptive Parents of two special needs siblings placed through the state foster care system. Our daughter, Makala, was 5-years-old and her biological brother Jeremiah was 1-year-old at the time they were placed for adoption in our family during 2003.

This has been an interesting and long four years. Our little girl has had several issues no one knew existed among them Alcohol-Related Neurodevelopmental Disorders, (ARND). Special Needs children adopted from the child services system often have continued benefits. Older, or special needs children usually receive Medicaid or State medical insurance coverage until the age of 18-years. Some children qualify for Adoption Assistance or Support, which is generally a monthly cash subsidy. These funds are designed to make it possible for families to provide special services for their children with special needs.

In some cases, families also have other medical insurance coverage. Employer Provided Group Health policies. When the adoptive parents of children with Medicaid or State Funded health coverage add the children to their private or employer provided group health policy it becomes the First and Primary Insurance with the Medicaid or State health insurance being Secondary coverage.

This is a similar situation some divorced families face as well. When parents divorce and both have benefits or employer provided health insurance or any other health coverage one parents insurance policy will be considered as the Primary and the other parent’s policy would be the Secondary policy. Often, the non-custodial or the parent liable for the payment of child support will be in the primary position.

The way the two health insurance policies work together can be technical at times. With any Medicaid or State health coverage parents may not even see all of the bills for medical or mental health services. Duel coverage often means any deductibles are paid, and co-payments are often waived. Typically, the primary insurance pays their maximum benefit and the secondary policy picks up any balances unpaid by the primary insurance.

When medical or especially mental health coverage turns into a big cost for an insurance company things can get interesting when families have duel health coverages. The past several weeks of my adoptive parenting has been a very interesting insurance journey! When there are two insurance coverages things can get complex, so look forward to my Blogs about working with your private or employer provided health insurance coverage and Medicaid or State benefits.

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For more information about parenting special needs children you might want to visit the Special Needs Blog and the Mental Health Blog. Or visit my personal website.