PRIVATE INSURANCE

Coverage is mandated for children, even prior to finalization. Federal law requires that any "Group Health Plan" extend their coverage to include a child placed in the home for adoption. There is no requirement that the adoption be finalized for insurance coverage to take effect.

For a child to be covered:

• Private medical insurance must be part of a Group Health Plan
• The Group Health Plan must subject to ERISA (see below)
• A parent must be a participant in the health plan
• Family coverage must be an option of the insurance coverage

Children placed for the purposes of adoption must be covered under the same terms and conditions as "birth" children. No child may be denied coverage due to a preexisting condition.

Most health plans contributed to by an employer are subject to ERIS A. Exceptions are government and church plans. Self-insured plans are not included in the mandate.

Omnibus Budget Reconciliation .pct of 1993 (OBRA '931, Section 609 Employee Retirement Income Security .pct (ERISA)

PUBLIC INSURANCE BENEFITS

All children in Foster Care are covered by public insurance. This is the Medicaid Program, called Medi-Cal in California. This insurance covers:

• Medical Care
• Dental Care
• Mental Health Resources
• Prescriptions

In California, Medi-Cal can cover co-payments on private insurance coverage; all eligible prescription costs and in involved cases, pays the cost of private insurance in lieu of full Medi-Cal coverage. These options may be available in other states.

If a family moves to another state, the new state must insure the child if that child was eligible for Medicaid in the prior state. The Adoption and Safe Families Act of 1997 guarantees public insurance to all eligible children adopted out of foster care. State vs. Federal eligibility for funding is no longer considered in insurance coverage.

For more information see: AAP Lecture Tape #3 "California, Foster Care and Medi-Cal"

This publication made possible by a grant from the Haigh-Scatena Foundation