How long can a disabled child
stay on parents health insurance?
CA law allows your incapacitated or disabled child over 26 to remain on the parents group or individual policy, indefinitely, as long as they were disabled before that.
An individual or group health insurance [“Health Insurance” … shall mean a policy that provides coverage for hospital, medical, or surgical benefits.§106 ] policy that provides that coverage of a dependent child shall terminate upon attainment of the limiting age [26 ACA] for dependent children specified in the policy, shall also provide that attainment of the limiting age shall not operate to terminate the coverage of the child while the child is and continues to meet both of the following criteria:
(1) Incapable of self-sustaining employment by reason of a physically or mentally disabling injury, [AB 88] illness, or condition.
“chiefly dependent” to mean that the person receives fifty per cent or more of his/her support from his/her parent(s), the insurance contract itself does not define “dependent.” The United States Court of Claims held in Odlin v. U.S., 74 Ct. Cl. 633, 636 (1932), that “chiefly dependent” does not have an explicit definition but rather “each case…must stand upon its own particular facts, and that no hard and fast rule can be laid down arbitrarily fixing the value of property, or the amount of income received…as entirely determinative of the question as to whether [a person] is ‘dependent’ within the meaning of the law.”
While the company’s interpretation of the phrase “chiefly dependent” doesn’t appear to be unreasonable, only a court of competent jurisdiction may make a conclusive determination. Learn More ⇒ Odlin v. U.S.
If your child is dependent on you, consider life insurance to take care of your child when you are gone. Disability in case you get ill and can’t work and Long Term Care, in case you can’t take care of yourself.
Email us your questions.
Considering that everything is guaranteed issue, with no Pre X starting 1.1.2014, I didn’t think this page would be relevant anymore, but it gets a ton of hits!
Links & Resources
Thus, dental coverage is not included. Dental does not ask about health, so Dental Coverage can be purchased here.
So, age 26 is not relevant, as long as the child meets the above definition and requirements of being disabled.
Dual Coverage – Which Insurance Company pays first? Medi-Cal, SSI, SSDI?
tacanow.org Autism Website – Their research & Ideas
New York NYSHIP Law findlaw.com/ny code 4305
Email us with your specific situation if in CA and we can send you an answer.
|Disabled Dependent Child
|Is an over-age disabled dependent eligible to continue coverage through this new insurance carrier if they were covered under their parents’ previous policy?|
|Is an over-age disabled dependent eligible to continue coverage through this new insurance carrier if they were not covered under their parents’ previous policy?|
|If the disabled child is eligible to continue coverage, what documentation will be required?|
|How often will the disabled dependent child be required to re-certify this disability?|
|Most of what the video says is RIGHT, not grandfathering though. Let me know if you find a video more on point|
Related Pages in Dependent Definition section
- Excerpts of law on disabled children-staying on parents policy
- Financial Support mandated of adult disabled child – SSI – SSDI
- Rules from Insurance Companies on coverage for disabled children
- Text of Law – Mandating coverage for disabled children