Re:establishing adult children as disabled for insurance?

[Guest guest]

Hello everyone- This is Faye Manaster, parent of an adult daughter and director of the federally-funded Arc of Illinois Family to Family Health Information and Education Center. Remaining on parent's insurance after age 18 due to "disability" is not a given. This is what the Illinois Insurance Code says about allowing youth with special health care needs to remain on their parent/guardian’s health insurance: 215 ILCS 5/356b) (from Ch. 73, par. 968b) Sec. 356b. (a) This Section applies to the

hospital and medical expense provisions of an accident or health insurance policy. ( If a policy provides that coverage of a dependent person terminates upon attainment of the limiting age for dependent persons specified in the policy, the attainment of such limiting age does not operate to terminate the hospital and medical coverage of a person who, because of a handicapped condition that occurred before attainment of the limiting age, is incapable of self‑sustaining employment and is dependent on his or her parents or other care providers for lifetime care and supervision. © For purposes of subsection (, "dependent on other care providers" is defined as requiring a Community Integrated Living Arrangement, group home, supervised apartment, or other residential services licensed or certified by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities), the Department of Public Health, or the Department of Public Aid. (d) The insurer may inquire of the policyholder 2 months prior to

attainment by a dependent of the limiting age set forth in the policy, or at any reasonable time thereafter, whether such dependent is in fact a disabled and dependent person and, in the absence of proof submitted within 60 days of such inquiry that such dependent is a disabled and dependent person may terminate coverage of such person at or after attainment of the limiting age. In the absence of such inquiry, coverage of any disabled and dependent person shall continue through the term of such policy or any extension or renewal thereof. (e) This amendatory Act of 1969 is applicable to policies issued or renewed more than 60 days after the effective date of this amendatory Act of

1969. (Source: P.A. 88‑309; 89‑507, eff. 7‑1‑97.) http://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=021500050HArt%2E+XX & ActID=1249 & ChapAct=215%26nbsp%3BILCS%26nbsp%3B5%2F & ChapterID=22 & ChapterName=INSURANCE & SectionID=52237 & SeqStart=107000 & SeqEnd=116500 & ActName=Illinois+Insurance+Code%2E It is important to pay close attention to the legal requirements for a “disabled adult child” to remain on his/her parent’s health insurance, while supporting your child’s plans for seeking and maintaining employment. This is another factor to consider during the transition process. For more detailed information about transition and health insurance options, please check

The Arc of Illinois Family Manual for Transition, Second Edition and review the comprehensive chapter (updated in September 2006) on health insurance: http://www.thearcofil.org/secure/reveal/admin/uploads/documents/FamilyManualOctober2006.pdf You can also visit our website, www.thearcofil.org/familytofamily or call us toll-free at 866-931-1110. Faye

[Guest guest]

Thank you, Faye.

Perhaps you know what proof would be required that would substantiate that a dependent son or daugher would qualify for continued coverage?

Would a psychiatric eval be necessary?

Thanks.

Ellen

Ellen Garber Bronfeldegskb@...

Re:establishing adult children as disabled for insurance?

Hello everyone-

This is Faye Manaster, parent of an adult daughter and director of the federally-funded Arc of Illinois Family to Family Health Information and Education Center.

Remaining on parent's insurance after age 18 due to "disability" is not a given.

This is what the Illinois Insurance Code says about allowing youth with special health care needs to remain on their parent/guardian’s health insurance:

215 ILCS 5/356b) (from Ch. 73, par. 968b) Sec. 356b. (a) This Section applies to the hospital and medical expense provisions of an accident or health insurance policy. ( If a policy provides that coverage of a dependent person terminates upon attainment of the limiting age for dependent persons specified in the policy, the attainment of such limiting age does not operate to terminate the hospital and medical coverage of a person who, because of a handicapped condition that occurred before attainment of the limiting age, is incapable of self‑sustaining employment and is dependent on his or her parents or other care providers for lifetime care and supervision. © For purposes of subsection (, "dependent on other care providers" is defined as requiring a Community Integrated Living Arrangement, group home, supervised apartment, or other residential services licensed or certified by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities), the Department of Public Health, or the Department of Public Aid. (d) The insurer may inquire of the policyholder 2 months prior to attainment by a dependent of the limiting age set forth in the policy, or at any reasonable time thereafter, whether such dependent is in fact a disabled and dependent person and, in the absence of proof submitted within 60 days of such inquiry that such dependent is a disabled and dependent person may terminate coverage of such person at or after attainment of the limiting age. In the absence of such inquiry, coverage of any disabled and dependent person shall continue through the term of such policy or any extension or renewal thereof. (e) This amendatory Act of 1969 is applicable to policies issued or renewed more than 60 days after the effective date of this amendatory Act of 1969. (Source: P.A. 88‑309; 89‑507, eff. 7‑1‑97.)

http://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=021500050HArt%2E+XX & ActID=1249 & ChapAct=215%26nbsp%3BILCS%26nbsp%3B5%2F & ChapterID=22 & ChapterName=INSURANCE & SectionID=52237 & SeqStart=107000 & SeqEnd=116500 & ActName=Illinois+Insurance+Code%2E

It is important to pay close attention to the legal requirements for a “disabled adult child” to remain on his/her parent’s health insurance, while supporting your child’s plans for seeking and maintaining employment. This is another factor to consider during the transition process.

For more detailed information about transition and health insurance options, please check The Arc of Illinois Family Manual for Transition, Second Edition and review the comprehensive chapter (updated in September 2006) on health insurance:

http://www.thearcofil.org/secure/reveal/admin/uploads/documents/FamilyManualOctober2006.pdf

You can also visit our website, www.thearcofil.org/familytofamily

or call us toll-free at 866-931-1110.

Faye

[Guest guest]

thank you for clarifying. Cindi

[Guest guest]

Thank you for the info, Faye. Can you explain what " certified by the

Department of Human Services " means in section C? It is my long term

expectation that we will need a CILA and it has been recommended by

her neuropsych. If one is getting funding does that mean they are

certified? It is my understanding that even though we are currently

receiving funding thru Home Based Services that does not guarantee

the admission to a CILA when it is needed.

I am currently paying a substantial amount to keep my daughter on my

insurance because one of the benefits I worked for was that my

disabled dependent would be kept on insurance for life.(she has not

yet qualified for Social Security or Medicaid). When I call the

insurance now and try to ask what will be required they tell me that

they cannot say at this time or until it becomes time for her to " age

out " when she is no longer a student (18 months from now). If I then

only have 60 days to " prove " the need, I don't know what I can do.

Any thoughts would be greatly appreciated. Gloria

>

> Hello everyone-

>

> This is Faye Manaster, parent of an adult daughter and director

of the federally-funded Arc of Illinois Family to Family Health

Information and Education Center.

>

> Remaining on parent's insurance after age 18 due to " disability "

is not a given.

>

>

> This is what the Illinois Insurance Code says about allowing

youth with special health care needs to remain on their

parent/guardian's health insurance:

>

> 215 ILCS 5/356b) (from Ch. 73, par. 968b)

> Sec. 356b. (a) This Section applies to the hospital and medical

expense provisions of an accident or health insurance policy.

> ( If a policy provides that coverage of a dependent person

terminates upon attainment of the limiting age for dependent persons

specified in the policy, the attainment of such limiting age does not

operate to terminate the hospital and medical coverage of a person

who, because of a handicapped condition that occurred before

attainment of the limiting age, is incapable of self & #8209;sustaining

employment and is dependent on his or her parents or other care

providers for lifetime care and supervision.

> © For purposes of subsection (, " dependent on other care

providers " is defined as requiring a Community Integrated Living

Arrangement, group home, supervised apartment, or other residential

services licensed or certified by the Department of Human Services

(as successor to the Department of Mental Health and Developmental

Disabilities), the Department of Public Health, or the Department of

Public Aid.

> (d) The insurer may inquire of the policyholder 2 months prior

to attainment by a dependent of the limiting age set forth in the

policy, or at any reasonable time thereafter, whether such dependent

is in fact a disabled and dependent person and, in the absence of

proof submitted within 60 days of such inquiry that such dependent is

a disabled and dependent person may terminate coverage of such person

at or after attainment of the limiting age. In the absence of such

inquiry, coverage of any disabled and dependent person shall continue

through the term of such policy or any extension or renewal thereof.

> (e) This amendatory Act of 1969 is applicable to policies

issued or renewed more than 60 days after the effective date of this

amendatory Act of 1969.

> (Source: P.A. 88 & #8209;309; 89 & #8209;507, eff. 7 & #8209;1 & #8209;97.)

> http://www.ilga.gov/legislation/ilcs/ilcs4.asp?

DocName=021500050HArt%2E+XX & ActID=1249 & ChapAct=215%26nbsp%3BILCS%

26nbsp%3B5%

2F & ChapterID=22 & ChapterName=INSURANCE & SectionID=52237 & SeqStart=107000 &

SeqEnd=116500 & ActName=Illinois+Insurance+Code%2E

>

> It is important to pay close attention to the legal requirements

for a " disabled adult child " to remain on his/her parent's health

insurance, while supporting your child's plans for seeking and

maintaining employment. This is another factor to consider during the

transition process.

>

> For more detailed information about transition and health

insurance options, please check The Arc of Illinois Family Manual for

Transition, Second Edition and review the comprehensive chapter

(updated in September 2006) on health insurance:

>

http://www.thearcofil.org/secure/reveal/admin/uploads/documents/Family

ManualOctober2006.pdf

>

> You can also visit our website, www.thearcofil.org/familytofamily

> or call us toll-free at 866-931-1110.

>

> Faye

>

[Guest guest]

Hello Faye, Thank you so much, I had no idea how to help this parent and I knew that someone in this group would be able too. I will forward this information to the parent who had asked me about the insurance. Thanks again, Faye Manaster <fayemanaster@...> wrote: Hello everyone- This is Faye Manaster, parent of an adult daughter and

director of the federally-funded Arc of Illinois Family to Family Health Information and Education Center. Remaining on parent's insurance after age 18 due to "disability" is not a given. This is what the Illinois Insurance Code says about allowing youth with special health care needs to remain on their parent/guardian’s health insurance: 215 ILCS 5/356b) (from

Ch. 73, par. 968b) Sec. 356b. (a) This Section applies to the hospital and medical expense provisions of an accident or health insurance policy. ( If a policy provides that coverage of a dependent person terminates upon attainment of the limiting age for dependent persons specified in the policy, the attainment of such limiting age does not operate to terminate the hospital and medical coverage of a person who, because of a handicapped condition that occurred before attainment of the limiting age, is incapable of self‑sustaining employment and is

dependent on his or her parents or other care providers for lifetime care and supervision. © For purposes of subsection (, "dependent on other care providers" is defined as requiring a Community Integrated Living Arrangement, group home, supervised apartment, or other residential services licensed or certified by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities), the Department of Public Health, or the Department of Public Aid. (d) The insurer may inquire of the policyholder 2 months prior to attainment by a

dependent of the limiting age set forth in the policy, or at any reasonable time thereafter, whether such dependent is in fact a disabled and dependent person and, in the absence of proof submitted within 60 days of such inquiry that such dependent is a disabled and dependent person may terminate coverage of such person at or after attainment of the limiting age. In the absence of such inquiry, coverage of any disabled and dependent person shall continue through the term of such policy or any extension or renewal thereof. (e) This amendatory Act of 1969 is applicable to policies issued or renewed more than 60 days after the effective date of this amendatory Act of 1969. (Source: P.A. 88‑309; 89‑507, eff. 7‑1‑97.) http://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=021500050HArt%2E+XX & ActID=1249 & ChapAct=215%26nbsp%3BILCS%26nbsp%3B5%2F & ChapterID=22 & ChapterName=INSURANCE & SectionID=52237 & SeqStart=107000 & SeqEnd=116500 & ActName=Illinois+Insurance+Code%2E It is important to pay close attention to the legal requirements for a “disabled adult child” to remain on his/her parent’s health insurance, while supporting your child’s plans for seeking and maintaining employment. This is another factor to consider during the transition process. For more detailed information about transition and health insurance options, please check The Arc of Illinois Family Manual for Transition, Second Edition and review the comprehensive chapter (updated in September 2006) on health insurance: http://www.thearcofil.org/secure/reveal/admin/uploads/documents/FamilyManualOctober2006.pdf You can also visit our website, www.thearcofil.org/familytofamily or call us toll-free at 866-931-1110. Faye

[Guest guest]

Re disability determination....the most common and most widely accepted "prooof" that is person is disabled is their status as an SSI recipient. Of course, many people with disabilities are not considered "disabled" by the Social Security Administration. If SSI has been denied (except in cases of being over income/over assets), one can always appeal. Contact Health and Disability Advocates, www.hdadvocates.org, for more information. Other types of"proof" may include IEPs from the person's most recent school years, and medical reports, as well as documentation from providers/DHS that a person is enrolled in a program or otherwise receiving services (for example, the CILA rate sheet). Unfortunately, if a person with a disability is working in a job that does not offer health insurance, this is not an adequate reason for them to

remain on parental innsurance. However, the person might be eligible for Health Benefits for Workers with Disabilties program, our state's Medicaid buy-in program. All of this- and more- is covered in great detail in the Arc Family Manual for Transition.. Let me know if any questions. Our email is familytofamily@... Faye

[Guest guest]

Thank you, Faye.

Ellen

Ellen Garber Bronfeldegskb@...

Re:establishing adult children as disabled for insurance?

Re disability determination....the most common and most widely accepted "prooof" that is person is disabled is their status as an SSI recipient.

Of course, many people with disabilities are not considered "disabled" by the Social Security Administration.

If SSI has been denied (except in cases of being over income/over assets), one can always appeal. Contact Health and Disability Advocates, www.hdadvocates.org, for more information.

Other types of"proof" may include IEPs from the person's most recent school years, and medical reports, as well as documentation from providers/DHS that a person is enrolled in a program or otherwise receiving services (for example, the CILA rate sheet).

Unfortunately, if a person with a disability is working in a job that does not offer health insurance, this is not an adequate reason for them to remain on parental innsurance.

However, the person might be eligible for Health Benefits for Workers with Disabilties program, our state's Medicaid buy-in program.

All of this- and more- is covered in great detail in the Arc Family Manual for Transition..

Let me know if any questions.

Our email is familytofamilythearcofil (DOT) org

Faye

[Guest guest]

Thank you, Faye! The info in the The Arc of Illinois Family Manual for Transition

is priceless!

Re:establishing adult children as disabled for insurance?

Hello everyone-

This is Faye Manaster, parent of an adult daughter and director of the federally-funded Arc of Illinois Family to Family Health Information and Education Center.

Remaining on parent's insurance after age 18 due to "disability" is not a given.

This is what the Illinois Insurance Code says about allowing youth with special health care needs to remain on their parent/guardian’s health insurance:

215 ILCS 5/356b)(from Ch. 73, par. 968b) Sec. 356b. (a) This Section applies to the hospital and medical expense provisions of an accident or health insurance policy. ( If a policy provides that coverage of a dependent person terminates upon attainment of the limiting age for dependent persons specified in the policy, the attainment of such limiting age does not operate to terminate the hospital and medical coverage of a person who, because of a handicapped condition that occurred before attainment of the limiting age, is incapable of self‑sustaining employment and is dependent on his or her parents or other care providers for lifetime care and supervision. © For purposes of subsection (, "dependent on other care providers" is defined as requiring a Community Integrated Living Arrangement, group home, supervised apartment, or other residential services licensed or certified by the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities), the Department of Public Health, or the Department of Public Aid. (d) The insurer may inquire of the policyholder 2 months prior to attainment by a dependent of the limiting age set forth in the policy, or at any reasonable time thereafter, whether such dependent is in fact a disabled and dependent person and, in the absence of proof submitted within 60 days of such inquiry that such dependent is a disabled and dependent person may terminate coverage of such person at or after attainment of the limiting age. In the absence of such inquiry, coverage of any disabled and dependent person shall continue through the term of such policy or any extension or renewal thereof. (e) This amendatory Act of 1969 is applicable to policies issued or renewed more than 60 days after the effective date of this amendatory Act of 1969. (Source: P.A. 88‑309; 89‑507, eff. 7‑1‑97.)

http://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=021500050HArt%2E+XX & ActID=1249 & ChapAct=215%26nbsp%3BILCS%26nbsp%3B5%2F & ChapterID=22 & ChapterName=INSURANCE & SectionID=52237 & SeqStart=107000 & SeqEnd=116500 & ActName=Illinois+Insurance+Code%2E

It is important to pay close attention to the legal requirements for a “disabled adult child” to remain on his/her parent’s health insurance, while supporting your child’s plans for seeking and maintaining employment. This is another factor to consider during the transition process.

For more detailed information about transition and health insurance options, please check The Arc of Illinois Family Manual for Transition, Second Edition and review the comprehensive chapter (updated in September 2006) on health insurance:

http://www.thearcofil.org/secure/reveal/admin/uploads/documents/FamilyManualOctober2006.pdf

You can also visit our website, www.thearcofil.org/familytofamily

or call us toll-free at 866-931-1110.

Faye

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